120 questions/tasks. Use the approved directions below.
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A six-year-old with ankle pain pulls away when you approach. The parent is beside the child, and the scene is safe. Which first approach is most likely to help you begin an assessment?
☐ A. Ask the parent to answer every question while you examine the child.
☐ B. Lower yourself to the child's eye level, introduce yourself, and explain one simple step.
☐ C. Begin palpating the ankle while describing the whole transport process.
☐ D. Ask the parent to leave so the child will concentrate on you.
Show answer and explanation
Response:B
Final answer:B. Lower yourself to the child's eye level, introduce yourself, and explain one simple step.
An eye-level introduction and a brief explanation of the next step let a frightened six-year-old participate with parental reassurance before the crew touches the injured ankle, reducing the chance that an abrupt examination will intensify resistance.
Question 2
An eight-month-old is conscious but cannot cry or cough after putting food in the mouth. You identify severe foreign-body airway obstruction. Which technique should you use?
☐ A. Repeat back blows alone without alternating with chest thrusts.
☐ B. Start chest compressions without first giving back blows.
☐ C. Alternate five back blows with five abdominal thrusts.
☐ D. Alternate five back blows with five chest thrusts.
Show answer and explanation
Response:D
Final answer:D. Alternate five back blows with five chest thrusts.
For a conscious infant with severe choking, alternate five back blows and five chest thrusts. Avoid abdominal thrusts. Loss of responsiveness changes the pathway to CPR, so the conscious-infant sequence cannot simply continue indefinitely.
Question 3
Dispatch reports a three-year-old with ineffective breathing on the fourth floor of a locked apartment building. Your partner is driving. Which TWO preparations most directly address this call before arrival?
Select exactly 2 answers.
☐ A. Clarify the entry method and whether equipment must be carried up the stairs.
☐ B. Check the pediatric mask fit and have the ventilation bag ready to carry in.
☐ C. Spend the remaining travel time obtaining the complete childhood immunization history.
☐ D. Request that the family bring the child to the lobby before you prepare pediatric equipment.
☐ E. Load the adult mask alone because a tighter seal can be created after arrival.
Show answer and explanation
Response:A, B
Final answer:A. Clarify the entry method and whether equipment must be carried up the stairs.; B. Check the pediatric mask fit and have the ventilation bag ready to carry in.
Clarifying entry to the locked fourth floor while checking the pediatric ventilation setup addresses two independent sources of delay, allowing the crew to carry fitted equipment directly to the poorly breathing child instead of relying on an unplanned move by the family.
Question 4
A 58-year-old sits leaning forward, speaks only two words at a time, and uses accessory muscles to breathe. You have not yet obtained a medical history. What general impression should guide the assessment?
☐ A. Likely isolated rapid breathing; reassess after coaching the patient to slow down.
☐ B. Established respiratory arrest; begin the pulseless-arrest sequence.
☐ C. Potentially critical respiratory distress; assess air movement and the need for immediate support.
☐ D. Primarily a circulatory emergency; obtain orthostatic pressures before assessing breathing.
Show answer and explanation
Response:C
Final answer:C. Potentially critical respiratory distress; assess air movement and the need for immediate support.
Limited speech and accessory-muscle use warrant an immediate air-movement assessment before the crew commits to coaching, oxygen or assisted ventilation. Speech is still possible. These observations support potentially critical distress without establishing respiratory arrest or its pulseless treatment sequence.
Question 5
A pediatric bag-mask device passes its valve check, but the mask cushion stays flattened and leaks during the supplied seal test. The checkout guide requires both checks to pass. What should you do before placing it in service?
☐ A. Replace the mask with a compatible one and repeat the assembled-device seal test.
☐ B. Accept the mask if the bag can be squeezed with less resistance than before.
☐ C. Repeat the valve-only test and return the same assembled device to service if it passes.
☐ D. Increase the oxygen flow and repeat the test without changing the leaking mask.
Show answer and explanation
Response:A
Final answer:A. Replace the mask with a compatible one and repeat the assembled-device seal test.
The valve passed, but the interface leaked. Replace the defective mask with a compatible one and repeat the assembled seal check, because the checkout rule requires both components to pass before this device enters service.
Question 6
An adult lies with eyes closed. When you call the patient's name, the patient opens the eyes and follows your request to squeeze a hand. Without continued speech, the eyes close again. What AVPU category describes the observed response?
☐ A. U: unresponsive.
☐ B. A: alert.
☐ C. V: responds to verbal stimulation.
☐ D. P: responds only to painful stimulation.
Show answer and explanation
Response:C
Final answer:C. V: responds to verbal stimulation.
V describes this voice-dependent response on AVPU. The patient follows a command purposefully yet closes the eyes when prompting stops, whereas an alert classification would require spontaneous interaction rather than continued verbal stimulation.
Question 7
An alert older adult says, ``I cannot hear you clearly.'' The room is noisy. Which adjustment should you try first?
☐ A. Raise your voice from behind the patient while continuing the examination.
☐ B. Repeat the question faster so the patient can catch more words.
☐ C. Reduce background noise, face the patient, and speak clearly at a normal pace.
☐ D. Ask a family member to provide the history without addressing the patient.
Show answer and explanation
Response:C
Final answer:C. Reduce background noise, face the patient, and speak clearly at a normal pace.
The patient reports hearing difficulty. Reduce background noise and face the patient at a clear, ordinary pace, allowing visual cues and a direct reply before involving a relative as a substitute historian.
Question 8
An adult is pulseless. A second rescuer is providing compressions. You are the AED operator; the device is not yet on and pads are not attached. Order these FIVE action packets. The AED will advise a shock. Follow its prompts, and minimize interruptions.
A.
Clear the patient for rhythm analysis.
B.
Attach the pads while the other rescuer continues compressions.
C.
Turn on the AED and expose the chest for pad placement.
D.
After shock advice, ensure everyone is clear and deliver the shock.
E.
Have compressions resume immediately after the shock.
Order: 1. 2. 3. 4. 5.
Show answer and explanation
Response:C B A D E
Final answer:C B A D E
Powering the AED and exposing the chest come before pad attachment. Keep compressions going during pad placement, clear for analysis and the advised shock, then resume compressions immediately after delivery to minimize interruptions in circulatory support.
Question 9
A caregiver reports that a two-month-old became limp and seemed not to breathe for a short period. The infant is now responsive and breathing normally. Which question best characterizes the reported event?
☐ A. Did the infant feed more or less than usual during the preceding day?
☐ B. During the spell, how did color, breathing, and responsiveness change, and how long did it last?
☐ C. Was the infant born early, and has there been a similar spell before?
☐ D. Has there been recent fever or contact with anyone who is ill?
Show answer and explanation
Response:B
Final answer:B. During the spell, how did color, breathing, and responsiveness change, and how long did it last?
Ask the caregiver to describe the spell: color, breathing, responsiveness and duration. Feeding, prematurity, previous spells and infection history can then add context once the actual event has been characterized.
Question 10
An unresponsive adult has no cough or gag reflex. The airway has been opened, but the tongue falls back when support is released. Facial injury raises concern for a basilar skull fracture; both oral and nasal basic adjuncts are available. Which is the preferred adjunct for this situation?
☐ A. A nasopharyngeal airway because an oral adjunct is reserved for patients who gag.
☐ B. A nasopharyngeal airway because facial injury makes the nasal route preferable.
☐ C. A bite block because it provides the same tongue support as an airway adjunct.
☐ D. A properly sized oropharyngeal airway, with continued airway and ventilation reassessment.
Show answer and explanation
Response:D
Final answer:D. A properly sized oropharyngeal airway, with continued airway and ventilation reassessment.
A fitted OPA supports the tongue. The absent gag and cough reflex allow its use here, and suspected skull-base injury favors the oral route over nasal insertion, followed by reassessment of airway patency and ventilation.
Question 11
At a chemical incident, command supplies these task categories: P = prevent entry into the contaminated area; D = decontaminate at the controlled exit; C = provide care on the clean side. Classify each assigned task using P, D, or C. Categories may be used more than once.
Codes: P: Prevent entry; D: Decontaminate; C: Clean-side care
Finding or action
Code
A.
Maintain the barrier that keeps bystanders out of the contaminated area.
B.
Help trained personnel remove contaminated outer clothing at the designated exit.
C.
Assess breathing after a patient has completed decontamination.
D.
Direct arriving ambulances to remain outside the entry barrier.
Show answer and explanation
Response:A=P; B=D; C=C; D=P
Final answer:A=P; B=D; C=C; D=P
P applies to the entry barrier and outside ambulance staging. D describes clothing removal at the controlled exit, and C describes clinical care after decontamination, separating each task's function from any question of who is qualified to enter a contaminated zone.
Question 12
A patient breathes six times per minute with shallow chest movement and becomes harder to arouse. A radial pulse is present. Which finding most strongly supports assisted ventilation rather than oxygen alone?
☐ A. A saturation of 94% measured while supplemental oxygen is flowing.
☐ B. A patent upper airway without visible secretions.
☐ C. Six shallow breaths per minute with progressively reduced responsiveness.
☐ D. A palpable radial pulse with a regular rhythm.
Show answer and explanation
Response:C
Final answer:C. Six shallow breaths per minute with progressively reduced responsiveness.
A pulse remains present. Six shallow breaths per minute and declining responsiveness require assisted ventilation, even when supplemental oxygen produces a reassuring saturation, because that display cannot establish adequate air movement.
Question 13
Before splinting a forearm injury, the hand was warm and had a palpable pulse. After the splint is secured, the hand becomes pale and the pulse is no longer palpable. What is the next action?
☐ A. Complete the remaining splint padding before investigating the new pulse loss.
☐ B. Elevate the splinted limb above the heart and see whether its color returns.
☐ C. Treat the pulse change as injury progression because immobilization has already been completed.
☐ D. Recheck and adjust the splint and straps promptly, then reassess distal circulation.
Show answer and explanation
Response:D
Final answer:D. Recheck and adjust the splint and straps promptly, then reassess distal circulation.
Recheck the splint promptly after the formerly pulsed hand becomes pale and pulseless. The change follows application. Correct possible pressure or alignment problems and reassess circulation, sensation and movement, documenting the sequence rather than treating the loss as a baseline finding.
Question 14
A supplied readiness checklist says an item is ready only if it meets its minimum count, is intact, and is unexpired. Mark each row R = ready or X = replace/replenish before service. Assess each row separately.
Codes: R: Ready; X: Replace/replenish
Proposal
R
X
A.
Minimum four adult masks; two sealed packs each contain two intact, unexpired adult masks.
B.
Minimum two pediatric masks; one intact pediatric mask and one intact adult mask are present.
C.
Minimum one naloxone device; the only device is past its labeled expiration date.
D.
Minimum two sterile dressings; one pack contains two dressings, but that pack is torn.
Show answer and explanation
Response:A=R; B=X; C=X; D=X
Final answer:A=R; B=X; C=X; D=X
Two valid packs of two adult masks meet the four-mask minimum. Pediatric stock is still short. The adult size cannot supply that missing pediatric unit, while the expired medicine and torn sterile package separately fail the stated usability criteria.
Question 15
After a fall, a patient has cool, clammy skin, a pulse of 124/min, and increasing restlessness. Blood pressure is 118/90 mmHg. What does this combination suggest?
☐ A. Hemorrhagic shock is unlikely until systolic pressure falls below 100 mmHg.
☐ B. Possible compensated shock with worsening perfusion despite maintained systolic pressure.
☐ C. An isolated pain response is the best explanation for the narrow pulse pressure and clammy skin.
☐ D. A primary vagal episode best explains the fast pulse and continued restlessness.
Show answer and explanation
Response:B
Final answer:B. Possible compensated shock with worsening perfusion despite maintained systolic pressure.
Clammy skin, restlessness, tachycardia and narrowing pulse pressure suggest impaired perfusion after trauma even while systolic pressure remains 118. Compensation may maintain pressure early. Waiting for a lower numerical threshold would overlook the existing clinical pattern.
Question 16
You expect blood to splash while caring for a heavily bleeding patient. Which PPE combination addresses both contact and splash exposure?
☐ A. Eye protection alone if your hands have no cuts.
☐ B. A surgical mask alone if the patient is not coughing.
☐ C. Gloves, protective clothing, and a mask with eye protection or a face shield as appropriate.
☐ D. Gloves alone if you avoid touching your face.
Show answer and explanation
Response:C
Final answer:C. Gloves, protective clothing, and a mask with eye protection or a face shield as appropriate.
Anticipated blood contact and splash determine the barrier combination: gloves, protective clothing and appropriate eye/face and mask protection cover exposed surfaces that gloves alone would leave vulnerable, regardless of whether the patient is coughing during this particular task.
Question 17
During the initial assessment of a collision patient, which THREE findings require immediate attention as primary-survey threats?
Select exactly 3 answers.
☐ A. Bleeding from a thigh wound rapidly soaking pressure dressings.
☐ B. A painful scalp wound with controlled bleeding; the patient answers questions appropriately.
☐ C. A closed wrist deformity with tingling but a warm hand and palpable pulse.
☐ D. A closed ankle deformity with swelling, normal distal pulses, and effective breathing.
☐ E. Shallow breathing with little chest movement despite attempted breaths.
☐ F. Blood and vomit interfering with airflow in the mouth.
Show answer and explanation
Response:A, E, F
Final answer:A. Bleeding from a thigh wound rapidly soaking pressure dressings.; E. Shallow breathing with little chest movement despite attempted breaths.; F. Blood and vomit interfering with airflow in the mouth.
The selected findings show uncontrolled major hemorrhage, ineffective ventilation and material obstructing airflow. Each needs immediate attention. The remaining injuries require assessment and treatment, but their perfused limbs, controlled bleeding and effective breathing place them below the identified primary threats.
Question 18
For this question, your authorized aspirin protocol requires suspected cardiac chest discomfort, no aspirin allergy, and confirmation that the protocol's permitted dose has not already been taken. The patient has cardiac-type discomfort and reports taking an unknown number of aspirin tablets today. What should you do before giving more?
☐ A. Clarify the prior dose and obtain protocol-directed medical guidance if it remains uncertain.
☐ B. Assume a usual household dose and subtract it from the permitted dose.
☐ C. Decide aspirin is permanently contraindicated because the number is unknown.
☐ D. Give the full permitted dose because chest discomfort overrides prior-dose uncertainty.
Show answer and explanation
Response:A
Final answer:A. Clarify the prior dose and obtain protocol-directed medical guidance if it remains uncertain.
The prior dose is unknown. Under the supplied aspirin permission rule, clarify what was taken and obtain protocol-directed guidance when needed before adding a dose, rather than converting a household-tablet guess into verified administration history.
Question 19
A worker is unconscious inside an industrial tank. The atmosphere has not been tested, and your EMT crew has no confined-space rescue training. What is the safest initial approach?
☐ A. Send the medically trained EMT in while the partner monitors from the opening.
☐ B. Stage outside, request a qualified confined-space team, and prevent unprotected entry.
☐ C. Use a normal oxygen-cylinder supply as breathing protection for a short entry.
☐ D. Have a worker make a brief entry because the worker knows the tank layout.
Show answer and explanation
Response:B
Final answer:B. Stage outside, request a qualified confined-space team, and prevent unprotected entry.
Stage outside the tank and obtain qualified confined-space rescue while preventing further unprotected entry. An untested atmosphere can disable rescuers. Ordinary medical oxygen, familiarity with the layout and clinical training do not establish safe confined-space entry capability.
Question 20
A five-year-old is lethargic with cool hands and weak peripheral pulses. The finger pulse oximeter repeatedly jumps between 88% and 99%, and its signal indicator is weak. Which interpretation is most appropriate?
☐ A. Choose the lowest displayed value as a confirmed measure of the child's hypoxemia.
☐ B. Use the highest displayed value because poor perfusion can only cause falsely low readings.
☐ C. Treat the signal as unreliable and assess/support the child while validating the measurement.
☐ D. Average repeated values after changing the display refresh rate.
Show answer and explanation
Response:C
Final answer:C. Treat the signal as unreliable and assess/support the child while validating the measurement.
Treat the lethargy and poor perfusion while validating the measurement at the sensor or another suitable site. The weak signal makes the displayed range unreliable, so selecting an extreme or averaging the numbers cannot turn it into confirmed oxygenation data.
Question 21
A child has a bruise on the left upper arm and says spontaneously, ``He grabbed me here.'' Which entry best preserves objective information?
☐ A. Left upper-arm bruise observed; child said, 'He grabbed me here,' pointing to that area.
☐ B. Left upper-arm bruise observed; presumed inflicted by the adult accompanying the child.
☐ C. Child reports being grabbed; describe the arm finding only as an assault injury.
☐ D. Left upper-arm bruise observed; child confirmed abuse by an adult whose identity was not established.
Show answer and explanation
Response:A
Final answer:A. Left upper-arm bruise observed; child said, 'He grabbed me here,' pointing to that area.
Document the observed bruise, its location and the child's attributed words with the area indicated. A perpetrator is not identified. This preserves the actual evidence for the applicable reporting process without replacing it with an unsupported conclusion about who caused the injury.
Question 22
You are called to a home for one person with headache and dizziness. A heater is running, and another adult in the same room reports similar symptoms. What should the crew recognize?
☐ A. Reconsider patient count and a shared environmental exposure before committing to indoor care.
☐ B. Keep the initial one-patient plan until the second adult's vital signs confirm illness.
☐ C. Treat the second adult as a helper because both complaints are nonspecific.
☐ D. Begin separate illness histories indoors before reassessing the running heater or scene.
Show answer and explanation
Response:A
Final answer:A. Reconsider patient count and a shared environmental exposure before committing to indoor care.
Reassess the room's shared hazard and consider the second symptomatic occupant a possible patient before continuing indoor care. Both report similar symptoms. The shared symptoms near an operating heater require a scene-hazard reassessment even though dispatch initially described one patient.
Question 23
An adult has a definite pulse and ineffective shallow breathing at 5/min. The airway has been cleared, and transport is being prepared while two rescuers begin bag-mask support. Which TWO ventilation targets should be included in the initial care plan, using the current pulse-present adult pathway?
Select exactly 2 answers.
☐ A. Deliver approximately one breath every six seconds, allowing exhalation.
☐ B. Compress the bag fully with each breath to ensure maximum oxygen delivery.
☐ C. Deliver each breath with enough volume to create visible chest rise.
☐ D. Set the assisted rate to 5/min because that matches the patient's original rate.
☐ E. Continue bagging at 30/min until the patient can follow commands.
Show answer and explanation
Response:A, C
Final answer:A. Deliver approximately one breath every six seconds, allowing exhalation.; C. Deliver each breath with enough volume to create visible chest rise.
Use about one breath every six seconds for this pulse-present adult, adjusting delivered volume to visible chest rise. Spontaneous breathing remains 5/min. That initial rate is inadequate, and emptying the whole bag risks excessive ventilation.
Question 24
A laboring patient is on a clean bed in a safe room. With a contraction, the infant's head is visible at the vaginal opening and does not withdraw. What should the EMT crew do next?
☐ A. Support the visible head while arranging transfer to the cot before delivery.
☐ B. Begin loading now because a first visible head can still retract between contractions.
☐ C. Use the safe room for birth, but leave newborn equipment in the ambulance until delivery.
☐ D. Prepare for delivery in the safe room with newborn-care equipment immediately ready.
Show answer and explanation
Response:D
Final answer:D. Prepare for delivery in the safe room with newborn-care equipment immediately ready.
Prepare delivery in the safe room with newborn equipment immediately ready, because the infant's head is visible with the contraction and does not withdraw, indicating an impending birth that an unnecessary cot transfer could interrupt.
Question 25
External bleeding has stopped after effective treatment. Over five minutes, the patient becomes more confused, pulse rises from 110 to 132/min, and blood pressure falls from 104/72 to 86/58 mmHg. What does reassessment show?
☐ A. A transient vasovagal response is most likely because the pressure fell after the wound was treated.
☐ B. Circulation is deteriorating despite visible hemorrhage control; another bleeding source or cause remains possible.
☐ C. The main problem is medication sedation because confusion preceded the repeat pressure measurement.
☐ D. Successful external control proves adequate circulating volume, so treat the faster pulse as pain alone.
Show answer and explanation
Response:B
Final answer:B. Circulation is deteriorating despite visible hemorrhage control; another bleeding source or cause remains possible.
Increasing confusion, tachycardia and falling pressure establish deteriorating perfusion after the wound stops bleeding. Control limits further visible loss. It does not restore lost volume or exclude another bleeding source, so continue shock support and urgent transport while reassessing the cause.
Question 26
An alert patient speaks little English. A qualified interpreter is immediately available, and the patient's urgent needs are being managed. How should you conduct the history?
☐ A. Ask a bilingual relative to summarize the history while the qualified interpreter waits.
☐ B. Use long complete explanations so the interpreter can translate everything in one turn.
☐ C. Direct the questions to the interpreter and let the interpreter decide which responses matter.
☐ D. Address the patient in short phrases, pausing for qualified interpretation and a reply.
Show answer and explanation
Response:D
Final answer:D. Address the patient in short phrases, pausing for qualified interpretation and a reply.
Address short questions to the patient and pause for the qualified interpreter and reply. The interpreter supports communication. That arrangement preserves the patient's direct participation, and short interpreted turns let the crew clarify details without handing the history to a relative or presenting an uninterrupted monologue.
Question 27
Use this supplied cot-loading procedure: position at the loading point before checking the safety hook; confirm the hook is engaged before releasing the undercarriage; secure the cot in the vehicle only after insertion. The patient is already secured to the cot. Order these FOUR action packets. This procedure is specific to the stated device.
A.
Release the undercarriage as directed and insert the cot.
B.
Verify engagement of the safety hook.
C.
Position the cot at the designated loading point with crew support.
D.
Engage and verify the cot's vehicle lock.
Order: 1. 2. 3. 4.
Show answer and explanation
Response:C B A D
Final answer:C B A D
Follow the supplied cot's dependencies: position with support, verify the safety hook, release and insert, then confirm the vehicle lock. The hook must engage first. Those explicit device instructions determine this order without implying that every cot uses the same mechanism.
Question 28
A patient with fever has become confused, has cool mottled skin, and breathes rapidly. A family member says, ``The fever is lower now, so the illness must be improving.'' What general impression is most appropriate?
☐ A. Possible serious infection with hypoperfusion despite the lower temperature.
☐ B. A simple febrile response with adequate perfusion because the fever is declining.
☐ C. A primarily behavioral change because rapid breathing still supplies adequate ventilation.
☐ D. A mild dehydration pattern that can be considered after completing a routine history.
Show answer and explanation
Response:A
Final answer:A. Possible serious infection with hypoperfusion despite the lower temperature.
The falling temperature cannot establish recovery when new confusion and mottling accompany rapid breathing in a patient with infection, so prioritize assessment and support for serious illness and impaired perfusion before collecting a routine fever history.
Question 29
For this incident, command supplies this simplified triage rule: I = needs an immediate airway, breathing, or major-bleeding intervention; D = unable to walk but has none of those immediate needs; M = can walk and has none. A nonwalking patient has normal breathing and a closed ankle deformity with bleeding controlled. Which category applies?
☐ A. M.
☐ B. I.
☐ C. D.
☐ D. No category can be assigned until the fracture type is known.
Show answer and explanation
Response:C
Final answer:C. D.
D follows the printed triage rule for a nonwalking patient without its immediate airway, breathing or major-bleeding criteria. The fracture type is unnecessary. Secondary examination and treatment can follow the initial assignment under that supplied local rule.
Question 30
After a difficult incident, responders describe the following symptoms. Classify each as P = physical, C = cognitive, or E = emotional. Use the symptom itself, not a diagnosis. Categories may repeat.
Codes: P: Physical; C: Cognitive; E: Emotional
Finding or action
Code
A.
Trembling hands.
B.
Difficulty concentrating on routine calculations.
C.
Feeling intense sadness when recalling the event.
D.
Repeatedly losing track of simple instructions.
Show answer and explanation
Response:A=P; B=C; C=E; D=C
Final answer:A=P; B=C; C=E; D=C
Tremor is physical, sadness is emotional, and problems concentrating or tracking instructions are cognitive. C therefore applies twice. These classifications describe the reported symptoms rather than diagnosing a psychiatric disorder from them.
Question 31
An older adult with marked chronic spinal curvature has back pain after a fall. Lying flat would force the neck into a painful position. Airway and breathing are adequate. Which approach best supports safe spinal motion restriction?
☐ A. Support the existing spinal contour with suitable padding and limit movement without forcing flat positioning.
☐ B. Use a flat rigid surface first, then adapt the padding only if breathing becomes impaired.
☐ C. Pad beneath the neck alone until the head rests flat, despite the patient's chronic curve.
☐ D. Manually straighten the spinal curve before securing the patient so the support fits evenly.
Show answer and explanation
Response:A
Final answer:A. Support the existing spinal contour with suitable padding and limit movement without forcing flat positioning.
Support the patient's usual chronic spinal contour with padding while limiting movement and checking breathing. Forcing the neck flat would impose a painful alignment change, so the motion-restriction plan must accommodate the individual instead of using a device shape as the treatment target.
Question 32
An adult abruptly becomes confused. The airway is open and breathing and circulation are supported. Your credentialed EMT scope permits point-of-care glucose testing. Which assessment should be obtained promptly as part of the search for a reversible cause?
☐ A. Obtain an authorized blood-glucose measurement while continuing the neurologic assessment.
☐ B. Complete a psychiatric screening before choosing a physiologic test.
☐ C. Use the absence of known diabetes to defer a glucose measurement.
☐ D. Wait for a full medication reconciliation before testing for low glucose.
Show answer and explanation
Response:A
Final answer:A. Obtain an authorized blood-glucose measurement while continuing the neurologic assessment.
Use the explicitly authorized glucose measurement to investigate a reversible contributor to sudden confusion while the broader assessment continues. Hypoglycemia remains possible. Neither the absence of known diabetes nor an incomplete medication list justifies deferring that available test.
Question 33
A patient was last seen speaking normally at 07:10. At 07:45, family found new facial droop and arm weakness. Which time distinction is most important to include in the stroke prearrival report?
☐ A. Last known well 07:45; discovered abnormal at 07:10.
☐ B. Onset exactly 07:45; last known well also 07:45.
☐ C. Last known well between 07:10 and 07:45; the interval is enough to replace both times.
☐ D. Last known well 07:10; symptoms discovered 07:45.
Show answer and explanation
Response:D
Final answer:D. Last known well 07:10; symptoms discovered 07:45.
Last known well is 07:10. Report that family observation and the 07:45 discovery separately, since the later discovery cannot pinpoint symptom onset anywhere within the intervening period.
Question 34
An unresponsive adult has vomit in the mouth, a definite pulse, and spontaneous breathing. You have suction and basic airway equipment. Which THREE actions belong in immediate airway care?
Select exactly 3 answers.
☐ A. Position appropriately and suction the visible vomit before continuing effective ventilation.
☐ B. Insert an oral adjunct through the pooled vomit to keep the tongue forward.
☐ C. Check chest rise and breathing adequacy after clearing the mouth.
☐ D. Use an appropriately sized basic adjunct if indicated and tolerated after clearance.
☐ E. Give assisted breaths through the pooled material first because a pulse is present.
☐ F. Apply high-flow oxygen by mask and defer suction while spontaneous breaths continue.
Show answer and explanation
Response:A, C, D
Final answer:A. Position appropriately and suction the visible vomit before continuing effective ventilation.; C. Check chest rise and breathing adequacy after clearing the mouth.; D. Use an appropriately sized basic adjunct if indicated and tolerated after clearance.
Remove the pooled vomit with appropriate positioning and suction, then reassess delivered air movement. Vomit is blocking the airway. A fitted, tolerated basic adjunct may maintain the airway afterward, but inserting it cannot remove the material already causing the obstruction.
Question 35
A patient is trapped in a vehicle down a steep embankment. Your crew can make safe contact, but the patient cannot be removed without stabilizing the vehicle and using rescue equipment. What additional resource should you request?
☐ A. Request an ALS crew and a second ambulance to provide advanced monitoring and extra personnel during extrication.
☐ B. Request a towing contractor to pull the occupied vehicle up to the road before the crew removes the patient.
☐ C. Request road-clearance personnel to control highway traffic and prepare a cot at the top of the embankment.
☐ D. Request technical rescue personnel with vehicle-stabilization and steep-terrain equipment.
Show answer and explanation
Response:D
Final answer:D. Request technical rescue personnel with vehicle-stabilization and steep-terrain equipment.
Stabilization is needed before the patient can be moved from this occupied vehicle, and the steep slope also requires a team equipped for safe access and extrication. Request technical rescue. Additional medical staff can support treatment, while towing and road-clearance personnel by themselves do not establish that both rescue capabilities are available.
Question 36
Four adults have a definite pulse and an open airway. Which assessment most strongly indicates that assisted ventilation is needed rather than oxygen alone?
☐ A. Alert, breathing 24/min with full chest movement and complete sentences; saturation 90%.
☐ B. Alert, wheezing at 28/min with adequate chest movement and short sentences.
☐ C. Alert, breathing 22/min after exertion, improving at rest without accessory-muscle use.
☐ D. Drowsy, breathing 34/min with minimal chest movement and decreasing ability to respond.
Show answer and explanation
Response:D
Final answer:D. Drowsy, breathing 34/min with minimal chest movement and decreasing ability to respond.
D has tiny chest movement and declining responsiveness despite a fast rate, making assisted ventilation the strongest concern among four patients whose other presentations retain better air movement, alert speech or improving effort even though they also need clinical assessment.
Question 37
For this question, the authorized nitroglycerin-assistance protocol requires asking about recent medication for erectile dysfunction before giving the patient's prescribed nitroglycerin. Which question most directly addresses that permission check?
☐ A. Have you ever used an over-the-counter cold remedy?
☐ B. Did the discomfort begin before or after your last meal?
☐ C. Do you usually take your medicine with breakfast?
☐ D. Have you taken sildenafil, tadalafil, or another erectile-dysfunction medicine recently, and when?
Show answer and explanation
Response:D
Final answer:D. Have you taken sildenafil, tadalafil, or another erectile-dysfunction medicine recently, and when?
Ask about the specific erectile-dysfunction medicine and when it was taken, then apply the printed nitroglycerin permission check. The interval is drug-specific. Meal history or a routine dosing description cannot answer the actual interaction question posed by this supplied protocol.
Question 38
A prepubertal seven-year-old is in cardiac arrest. Two trained rescuers are providing CPR without an advanced airway. For each proposal, mark Y = consistent with current pediatric BLS or N = not consistent. Judge each independently.
Codes: Y: Consistent; N: Not consistent
Proposal
Y
N
A.
Use 15 compressions for every two breaths before an advanced airway is placed.
B.
Set the compression rate within 100--120/min.
C.
Release pressure between compressions to allow full recoil.
D.
Give five minutes of CPR before attaching an AED that is already ready for use.
Show answer and explanation
Response:A=Y; B=Y; C=Y; D=N
Final answer:A=Y; B=Y; C=Y; D=N
The first three proposals fit two-rescuer prepubertal BLS: 15:2, 100--120 compressions per minute and full recoil. Use the ready AED promptly. Its availability eliminates any justification for the final proposal's arbitrary five-minute delay.
Question 39
A patient has rapid, life-threatening bleeding from a lower-leg wound. Direct pressure cannot be maintained during a necessary rescue move. A tourniquet is available, and its use is authorized. What should take priority?
☐ A. Apply the authorized tourniquet and verify hemorrhage control before and after movement.
☐ B. Pack the extremity wound, then move without maintaining pressure because the packing occupies the space.
☐ C. Use elevation alone during the move, reserving the tourniquet for a later fall in pressure.
☐ D. Apply a pressure dressing and move without checking whether it controls the rapid bleeding.
Show answer and explanation
Response:A
Final answer:A. Apply the authorized tourniquet and verify hemorrhage control before and after movement.
Apply the authorized tourniquet and verify control through the rescue move. Pressure cannot be maintained. This is life-threatening extremity hemorrhage, and a dressing's presence or wound packing without effective pressure would not establish that blood loss has stopped before movement.
Question 40
The supplied suction checkout guide requires sustained suction after the tubing is connected. The unit passes without tubing but loses suction with its current tubing; a spare set of tubing passes the full test. What is the appropriate equipment action?
☐ A. Replace the pump because any connected-system failure proves the pump is inadequate.
☐ B. Return the original tubing to service because the disconnected pump test passed.
☐ C. Replace the original tubing and confirm sustained suction in the complete working setup.
☐ D. Replace the collection canister first and accept the original tubing without another complete test.
Show answer and explanation
Response:C
Final answer:C. Replace the original tubing and confirm sustained suction in the complete working setup.
The complete suction setup works when only the tubing changes, isolating the demonstrated fault to the original tubing. Replace it and retest. A pump-only result bypasses the failed component and cannot certify the assembled system for patient use.
Question 41
Dispatch updates a shooting call: the suspected shooter is still inside, and police have not secured access. Your ambulance is two minutes away. What should change in the approach plan?
☐ A. Use a sheltered rear entrance while police continue clearing the front of the building.
☐ B. Approach in view of officers because the reported patient needs urgent hemorrhage care.
☐ C. Ask an unprotected bystander to escort the crew in by the patient's reported route.
☐ D. Stage safely and coordinate entry after law enforcement establishes appropriate access.
Show answer and explanation
Response:D
Final answer:D. Stage safely and coordinate entry after law enforcement establishes appropriate access.
The updated weapon report changes the prearrival approach to safe staging and police-coordinated access. Entry remains unsecured. A rear doorway or visibility to an officer supplies no actual clearance of the ongoing threat.
Question 42
An infant has been removed safely from a smoky room. Which TWO findings are immediate breathing or airway threats during the primary assessment?
Select exactly 2 answers.
☐ A. New stridor with marked effort and little air movement.
☐ B. Minimal chest rise and progressively reduced responsiveness.
☐ C. Hoarse crying with effective air movement, normal effort, and normal responsiveness.
☐ D. A painful forearm burn with effective breathing and strong pulses.
☐ E. Soot at the nostrils while the infant cries strongly with effective chest movement.
Show answer and explanation
Response:A, B
Final answer:A. New stridor with marked effort and little air movement.; B. Minimal chest rise and progressively reduced responsiveness.
Stridor with little air movement shows an immediate airway threat, while minimal chest rise and decreasing responsiveness indicate poor ventilation. Select findings A and B. Hoarseness or soot still warrants repeated airway assessment, but the effective breathing and responsiveness specified in the other alternatives distinguish those findings from the two immediate failures.
Question 43
After blunt injury, an unresponsive adult has a definite pulse but cannot be ventilated effectively. Manual spinal support continues. Jaw thrust and a correctly fitted, tolerated oral adjunct have failed to open the airway; visible secretions are also present. Which THREE basic actions are appropriate now?
Select exactly 3 answers.
☐ A. Continue jaw thrust alone and postpone ventilation until a rigid collar is applied.
☐ B. Suction the visible secretions.
☐ C. Reassess chest rise while assisted breaths are delivered.
☐ D. Leave the same adjunct in place and increase bag pressure without changing airway positioning.
☐ E. Use head tilt--chin lift as needed after the failed jaw thrust and adjunct, preserving spinal support as practical.
☐ F. Replace the oral adjunct with a larger one without reassessing fit, because the first attempt failed.
Show answer and explanation
Response:B, C, E
Final answer:B. Suction the visible secretions.; C. Reassess chest rise while assisted breaths are delivered.; E. Use head tilt--chin lift as needed after the failed jaw thrust and adjunct, preserving spinal support as practical.
Current guidance permits needed head tilt--chin lift after jaw thrust and a suitable adjunct both fail, maintaining practical spinal support while clearing visible secretions and checking assisted chest rise to determine whether the revised opening maneuver has restored effective air movement.
Question 44
An adult rescued from water is unresponsive, apneic, and pulseless. A trained crew has a bag-mask device ready, but the AED will arrive in about one minute. Which plan is appropriate now?
☐ A. Use ventilation alone because the arrest began with an oxygen problem.
☐ B. Give compressions alone until the AED arrives, although trained ventilation support is ready.
☐ C. Pause resuscitation preparations until an AED rhythm can guide the first action.
☐ D. Begin CPR that includes breaths without waiting for the AED.
Show answer and explanation
Response:D
Final answer:D. Begin CPR that includes breaths without waiting for the AED.
Begin CPR including breaths for the pulseless drowning patient with trained rescuers and ventilation equipment ready. The AED is still coming. Breathing support alone cannot supply circulation, and device arrival must not become a condition for starting arrest care.
Question 45
An alert adult has new slurred speech and unilateral weakness. Airway and breathing are adequate. Your scope permits blood-glucose testing. Why should a glucose value be obtained promptly?
☐ A. A low glucose value distinguishes hemorrhagic from ischemic stroke.
☐ B. Low glucose can cause or contribute to acute neurologic deficits and may be treatable.
☐ C. Any low glucose result establishes that the focal findings are unrelated to stroke.
☐ D. Normal glucose rules out a metabolic or neurologic emergency needing transport.
Show answer and explanation
Response:B
Final answer:B. Low glucose can cause or contribute to acute neurologic deficits and may be treatable.
Glucose testing can reveal a treatable cause or contributor to the new focal neurological findings. A low result does not locate a stroke, distinguish its subtype or exclude coexisting stroke, so use it to guide authorized treatment and continued assessment.
Question 46
Use the supplied cylinder formula: usable minutes = (gauge pressure 200 psi reserve) 0.16 flow. A cylinder reads 1,000 psi; flow is 8 L/min. The planned journey takes 20 minutes, without additional delays. What does the calculation show?
☐ A. The cylinder provides about 16 usable minutes, so a ready backup is needed.
☐ B. The cylinder provides 24 usable minutes and covers the journey.
☐ C. The cylinder provides 20 usable minutes and covers the journey exactly.
☐ D. The cylinder provides 128 usable minutes and easily covers the journey.
Show answer and explanation
Response:A
Final answer:A. The cylinder provides about 16 usable minutes, so a ready backup is needed.
Subtract the 200-psi reserve: 800 0.16 gives 128 usable liters, and 128 8 gives 16 minutes. The trip takes 20 minutes. Bring a ready backup supply because the calculated usable cylinder duration is already shorter than the stated journey.
Question 47
An adult has a definite pulse and vomit blocking the airway. An attempted assisted breath produces no chest rise. The following packets are dependent: effective ventilation requires clearing the obstruction; moving to transport requires established ongoing ventilation; the detailed examination occurs during transport only after immediate support is established. Order all FOUR packets.
A.
Perform the detailed secondary examination as ongoing care permits.
B.
Establish assisted breaths with visible chest rise.
C.
Clear the airway with appropriate positioning and suction.
D.
Begin rapid transport while assisted ventilation continues.
Order: 1. 2. 3. 4.
Show answer and explanation
Response:C B D A
Final answer:C B D A
The first attempted breath failed. Clear the obstructing material, establish breaths with visible chest rise, then maintain that support during transport before completing detailed secondary work as care permits under the supplied sequence.
Question 48
A patient lies beside a damaged electrical installation. The source is still energized, and qualified personnel have not declared the area safe. Which access decision is appropriate?
☐ A. Approach after putting on a second pair of dry medical gloves.
☐ B. Keep clear until qualified personnel control the electrical hazard and confirm safe access.
☐ C. Approach from the opposite side because the visible damage is confined to one side.
☐ D. Move the patient with an ordinary wooden object found nearby before the source is isolated.
Show answer and explanation
Response:B
Final answer:B. Keep clear until qualified personnel control the electrical hazard and confirm safe access.
Wait for qualified energy control and access clearance before approaching the electrical hazard. It remains energized. Medical gloves, an improvised pole and a different approach angle cannot establish the protection needed for a safe rescue.
Question 49
A traumatically amputated finger has been recovered. The patient's bleeding is controlled, and transport is ready. Which preservation method is appropriate?
☐ A. Immerse the finger directly in ice water without a sealed bag.
☐ B. Protect the part in a plastic bag, then cool that bag on ice inside a second bag.
☐ C. Place the unprotected finger directly against ice.
☐ D. Delay the patient's transport until ice can be collected from another building.
Show answer and explanation
Response:B
Final answer:B. Protect the part in a plastic bag, then cool that bag on ice inside a second bag.
Seal the protected finger in an inner bag and cool that bag within an ice-containing outer bag. Avoid direct ice contact. This preserves cooling without freezing or soaking tissue, and preparation must proceed alongside needed patient transport rather than holding departure for supplies.
Question 50
Mark each communication approach A = appropriate for the stated situation or C = counterproductive. The patients are alert, and urgent care continues as needed.
Codes: A: Appropriate; C: Counterproductive
Finding or action
Code
A.
Reduce room noise and face a patient who reports difficulty hearing.
B.
Address the patient directly while a qualified interpreter translates short exchanges.
C.
Give an anxious child the whole procedure sequence before allowing questions.
D.
Ask a patient using a communication device to sign consent without first allowing a response through that device.
Show answer and explanation
Response:A=A; B=A; C=C; D=C
Final answer:A=A; B=A; C=C; D=C
Noise reduction, face-to-face exchange and short patient-directed interpretation make the first two approaches accessible, whereas an uninterrupted explanation to the anxious child or a signature obtained before allowing device-supported replies deprives the other patients of a usable opportunity to understand and respond.
Question 51
An awake patient with confirmed low glucose was given authorized oral glucose while able to swallow. During reassessment, the patient becomes drowsy and cannot manage saliva. What should change?
☐ A. Continue the original oral dose because the patient could swallow when it was begun.
☐ B. Stop further oral dosing, reassess airway and breathing, and obtain additional authorized care.
☐ C. Place glucose against the cheek instead of having the patient swallow, without changing the care plan.
☐ D. Wait for a repeat glucose value before addressing the new inability to manage saliva.
Show answer and explanation
Response:B
Final answer:B. Stop further oral dosing, reassess airway and breathing, and obtain additional authorized care.
Swallowing is no longer safe. Stop additional oral glucose and reassess airway and breathing while arranging further authorized care, because the new inability to manage saliva takes precedence over the earlier swallowing ability or a scheduled repeat glucose check.
Question 52
An adult found with suspected opioid exposure initially breathed 4/min. After airway support and authorized naloxone, the patient briefly opens the eyes but still has shallow breathing at 4/min and a definite pulse. What general impression should guide continued immediate care?
☐ A. Successful reversal with adequate ventilation because eye opening has returned.
☐ B. Persistent respiratory failure despite a partial response; effective ventilation remains necessary.
☐ C. A primary behavioral problem because the patient responded to treatment.
☐ D. Cardiac arrest because the breathing rate remains below the normal range.
Show answer and explanation
Response:B
Final answer:B. Persistent respiratory failure despite a partial response; effective ventilation remains necessary.
Continue effective ventilation with the authorized overdose response while reassessing the patient. Four shallow breaths remain inadequate. Brief eye opening shows only partial improvement and cannot establish that independent breathing has recovered in this patient with a definite pulse.
Question 53
A patient with a definite pulse is receiving assisted ventilation for suspected opioid overdose. You are authorized to use the supplied NARCAN 4 mg single-dose nasal device. Which TWO actions agree with this device's instructions?
Select exactly 2 answers.
☐ A. If a repeat dose is indicated, use a new device and alternate nostrils at the labeled 2--3-minute interval.
☐ B. Divide the contents of the same device equally between nostrils.
☐ C. Test-spray the device before placing it in the nostril.
☐ D. Give the entire contents of one device into one nostril without priming it.
☐ E. Refill and reuse the first device for a repeat dose.
Show answer and explanation
Response:A, D
Final answer:A. If a repeat dose is indicated, use a new device and alternate nostrils at the labeled 2--3-minute interval.; D. Give the entire contents of one device into one nostril without priming it.
An indicated NARCAN repeat requires a new single-use device in the alternate nostril at the labeled 2--3-minute interval, delivering its complete dose without priming while ventilation continues, rather than dividing or refilling a device designed for one nasal administration.
Question 54
Your crew must enter a home to assess a patient with suspected infectious pulmonary tuberculosis. Which respiratory protection is appropriate for this entry?
☐ A. A surgical mask as the responder's only respiratory protection.
☐ B. Gloves alone if the patient is not actively coughing.
☐ C. A fit-tested, NIOSH-approved N95 respirator or higher protection.
☐ D. A face shield without a respirator.
Show answer and explanation
Response:C
Final answer:C. A fit-tested, NIOSH-approved N95 respirator or higher protection.
Use a fit-tested, NIOSH-approved N95 or higher protection for this home entry involving suspected infectious pulmonary TB. Airborne precautions apply. Gloves, a surgical mask or a face shield alone cannot provide the responder's required respiratory barrier.
Question 55
An alert patient reports accidentally swallowing a liquid medicine. You know the product name, the estimated time, and that no other substance was taken. Which missing detail is most important to clarify next for the exposure history?
☐ A. Whether the same medicine had been prescribed for a previous illness.
☐ B. The estimated volume swallowed, including how much may be missing from the bottle.
☐ C. Whether the patient usually takes the medicine with food.
☐ D. Whether the patient prefers a different brand with the same listed ingredients.
Show answer and explanation
Response:B
Final answer:B. The estimated volume swallowed, including how much may be missing from the bottle.
Clarify the estimated swallowed volume, including what may be missing from the bottle. The product is already known. Quantifying this exposure adds the important missing history without assuming that accidental ingestion means a small or harmless amount.
Question 56
Use the supplied adult GCS table. A patient opens eyes to speech, gives confused verbal responses, and obeys commands. What is the total score?
Eye opening
Verbal response
Motor response
4: Spontaneous
5: Oriented
6: Obeys commands
3: To speech
4: Confused
5: Localizes pain
2: To pain
3: Inappropriate words
4: Withdraws from pain
1: None
2: Incomprehensible sounds
3: Abnormal flexion
1: None
2: Abnormal extension
1: None
☐ A. 13.
☐ B. 14.
☐ C. 15.
☐ D. 12.
Show answer and explanation
Response:A
Final answer:A. 13.
The supplied table assigns 3 to eyes opening on speech, 4 to confused verbal responses and 6 to obeying commands, giving 13 because the observations establish neither spontaneous eye opening nor the oriented verbal response that would increase those components.
Question 57
A supplied reporting policy records the targeted response separately from any new complication. After an authorized inhaled treatment, wheezing decreases and the patient develops new tremor. Which entry follows that policy?
☐ A. Wheezing decreased after treatment; tremor was present before treatment.
☐ B. Wheezing decreased after treatment; no new problem because the breathing symptom improved.
☐ C. New tremor after treatment; respiratory response could not be determined despite decreased wheezing.
☐ D. Wheezing decreased after treatment; new tremor developed afterward.
Show answer and explanation
Response:D
Final answer:D. Wheezing decreased after treatment; new tremor developed afterward.
Record the reduced wheezing and subsequent tremor as separate observations in their true sequence. Tremor is new. Preserving both findings lets the receiving clinician assess the targeted response and later complication without falsely moving either event into the pretreatment baseline.
Question 58
A patient in late pregnancy is conscious but cannot speak or cough because of severe choking. Which current adult BLS technique is appropriate?
☐ A. Perform a blind finger sweep before giving thrusts.
☐ B. Give abdominal thrusts at a lower position than usual.
☐ C. Alternate five back blows with five chest thrusts.
☐ D. Alternate five back blows with five abdominal thrusts.
Show answer and explanation
Response:C
Final answer:C. Alternate five back blows with five chest thrusts.
Alternate five back blows with five chest thrusts for severe choking in late pregnancy. Pregnancy changes the thrust site. Abdominal thrusts are replaced here, and unresponsiveness would instead call for the CPR pathway.
Question 59
Immediately after an uncomplicated birth, a full-term newborn cries strongly, has good tone, and needs no resuscitation. Mark each proposal Y = appropriate initial care or N = not appropriate for these findings.
Codes: Y: Appropriate; N: Not appropriate
Proposal
Y
N
A.
Dry and maintain warmth while observing breathing and tone.
B.
Provide safe skin-to-skin contact with thermal protection and continued observation.
C.
Suction the mouth and nose before skin-to-skin care despite a clear airway and strong cry.
D.
Start assisted breaths for the initial transitional period despite effective crying and good tone.
Show answer and explanation
Response:A=Y; B=Y; C=N; D=N
Final answer:A=Y; B=Y; C=N; D=N
Dry the vigorously crying newborn, conserve warmth and provide protected skin-to-skin contact with observation of breathing and tone. The airway is clear. Those findings supply no indication for routine suction or assisted breaths during the initial transition.
Question 60
At a two-vehicle collision, three adults are being assessed. A witness says a rear-facing child seat was occupied before the collision, but the seat is now empty and no child has been identified. What should you do?
☐ A. Use the three adults as the current total and defer the discrepancy until transport.
☐ B. Notify command of the occupied-seat report and coordinate a safe search while adult care continues.
☐ C. Ask one medically assigned responder to leave the patients and search the uncleared area alone.
☐ D. Declare a confirmed fourth critical patient from the seat report and assign final triage remotely.
Show answer and explanation
Response:B
Final answer:B. Notify command of the occupied-seat report and coordinate a safe search while adult care continues.
Report the unresolved occupied-seat discrepancy to command and coordinate a safe search while care for the identified adults continues. The child's condition is unknown. A witness's report justifies additional accountability work, without establishing a final triage category for an unseen patient.
Question 61
A nine-month-old initially had fast breathing with retractions. Now the respiratory rate is slower, chest movement is faint, and the infant is limp and less responsive. Which interpretation best fits the change?
☐ A. The reduced effort is consistent with recovery if the infant no longer has loud wheezing.
☐ B. The slower rate is reassuring as long as supplemental oxygen remains available.
☐ C. The fading effort, tone, and responsiveness suggest developing respiratory failure.
☐ D. A transient hypoxic spell has resolved, leaving residual low tone while respiratory effort recovers.
Show answer and explanation
Response:C
Final answer:C. The fading effort, tone, and responsiveness suggest developing respiratory failure.
Declining chest movement, tone and responsiveness after vigorous breathing effort suggest an infant tiring into respiratory failure. Assess and support breathing promptly. Fainter sounds or a slower rate cannot be interpreted as improvement when the amount of air moved and interaction are worsening together.
Question 62
A supplied transport protocol directs unstable patients to the nearest appropriate hospital and permits ALS intercept only if it does not delay that trip. Hospital travel is 12 minutes; an ALS unit can meet you along the route in 5 minutes. Which THREE planning actions follow the protocol?
Select exactly 3 answers.
☐ A. Transfer to the ALS vehicle even if stopping for the transfer delays the nearest appropriate hospital arrival.
☐ B. Begin the direct hospital trip while the required basic support continues.
☐ C. Secure equipment so the crew can safely reach and use it during continuing care.
☐ D. Choose an off-route rendezvous because its parking area is easier, despite the extra hospital travel.
☐ E. Hold departure until the ALS crew confirms every detail of its medication plan.
☐ F. Arrange the on-route intercept without waiting or adding a destination delay.
Show answer and explanation
Response:B, C, F
Final answer:B. Begin the direct hospital trip while the required basic support continues.; C. Secure equipment so the crew can safely reach and use it during continuing care.; F. Arrange the on-route intercept without waiting or adding a destination delay.
Begin the direct trip with basic support and accessible, secured equipment while coordinating the on-route ALS intercept. Hospital arrival must not be delayed. The supplied rule excludes waiting for medication planning or detouring merely to make the transfer more convenient.
Question 63
A correctly indicated tourniquet has been applied for severe thigh bleeding, but brisk bleeding continues. What should the authorized EMT do next?
☐ A. Move the same tourniquet farther distally because the thigh wound is still bleeding.
☐ B. Add loose wound packing around the tourniquet and accept slow continued loss.
☐ C. Reapply direct pressure and remove the tourniquet before checking whether it was tight enough.
☐ D. Check placement and tightness, then add a second proximal tourniquet if needed under protocol.
Show answer and explanation
Response:D
Final answer:D. Check placement and tightness, then add a second proximal tourniquet if needed under protocol.
Reassess placement and tightening until hemorrhage is controlled, adding a second proximal device when indicated by the authorized protocol. Bleeding is still ongoing. Removal of the first tourniquet before control, distal relocation or accepting continued loss cannot achieve the required endpoint.
Question 64
After an extended shift, an EMT driver repeatedly drifts toward the shoulder and struggles to keep the eyes open. What is the safest response?
☐ A. Finish the current transport faster and report the issue only after the shift.
☐ B. Stop driving safely, report the impairment, and arrange a rested replacement according to policy.
☐ C. Take a brief stimulant break and resume driving without reassessing fitness or reporting the near-misses.
☐ D. Have the partner provide verbal reminders while the same EMT keeps driving.
Show answer and explanation
Response:B
Final answer:B. Stop driving safely, report the impairment, and arrange a rested replacement according to policy.
Stop safely, report the driving impairment and arrange a rested replacement through agency policy. Roadway drifting demonstrates current danger. A stimulant or a partner's verbal reminders cannot be treated as verified restoration of safe alertness for the remainder of this trip.
Question 65
A runner becomes confused and collapses during exercise on a hot day. The skin is hot and still sweaty. Which conclusion should guide care?
☐ A. Possible severe exertional heat illness; begin urgent cooling and supportive care.
☐ B. Simple heat cramps, since active sweating excludes dangerous temperature elevation.
☐ C. Uncomplicated heat syncope, despite persistent confusion after the collapse.
☐ D. Expected exercise fatigue; defer cooling while observing whether the confusion clears.
Show answer and explanation
Response:A
Final answer:A. Possible severe exertional heat illness; begin urgent cooling and supportive care.
Begin urgent cooling and supportive care for heat-associated collapse with persistent confusion. Sweating does not exclude heatstroke. The neurological change separates this presentation from isolated cramps or an uncomplicated faint followed by prompt normal recovery.
Question 66
Use command's supplied rule: I = immediate breathing support or uncontrolled major bleeding; D = nonwalking without either immediate need. A patient initially assigned D now has weak, inadequate breaths and needs assisted ventilation. What is the correct triage action?
☐ A. Change to I and begin assisted ventilation because the new finding meets the rule.
☐ B. Keep D until a second responder independently confirms the entire secondary assessment.
☐ C. Keep D while providing ventilation because labels describe only the first examination.
☐ D. Move to a lower-priority category because the respiratory rate has decreased.
Show answer and explanation
Response:A
Final answer:A. Change to I and begin assisted ventilation because the new finding meets the rule.
Update the triage assignment to I and supply the newly required assisted ventilation. The original category no longer fits. Repeated assessment can change a local-rule category, so the earlier D tag cannot override current breathing failure.
Question 67
At the start of a call, the unit has four intact, unexpired single-dose naloxone devices and one expired device. Two unexpired devices are used during care. Agency policy requires three usable devices before the unit returns to service. How many new devices are needed after the call?
☐ A. None, because three physical devices remain.
☐ B. Two, because every device used on a call must be replaced regardless of the minimum.
☐ C. One, because two usable devices remain and the minimum is three.
☐ D. Three, to replace the two administered devices and the expired device.
Show answer and explanation
Response:C
Final answer:C. One, because two usable devices remain and the minimum is three.
Four unexpired devices minus two administered leaves two usable devices. Add one to reach three. Exclude the expired unit from the usable count, and meet the requested minimum rather than automatically replacing every device that was used during the call.
Question 68
The supplied handoff procedure uses four packets in this exact order: identify the patient and immediate problem; give relevant background; report current assessment and care; state the remaining need. Order these FOUR packets for the patient described by their content.
A.
Adult with severe breathing difficulty requiring assisted breaths.
History of asthma; symptoms began suddenly about 20 minutes ago.
D.
Continued ventilation and prompt receiving-team assessment are needed.
Order: 1. 2. 3. 4.
Show answer and explanation
Response:A C B D
Final answer:A C B D
The packets have distinct roles. The supplied sequence puts identity and the immediate problem first, then asthma and onset as background, followed by current assessment and ventilation response and finally the remaining need, giving A, C, B, D.
Question 69
An adult with cold hands has a finger SpO2 of 97% with a weak signal. After changing to an approved site and obtaining a stable signal, repeated readings are 93%. The patient remains confused with shallow breathing. Which interpretation is best supported?
☐ A. The first 97% establishes the patient's true oxygenation because it was obtained before changing sites.
☐ B. A stable 93% establishes adequate ventilation and excludes a cause of confusion related to breathing.
☐ C. The stable reading is more credible than the weak-signal value, but breathing adequacy still requires clinical assessment.
☐ D. The two site readings should be averaged to establish a more accurate baseline.
Show answer and explanation
Response:C
Final answer:C. The stable reading is more credible than the weak-signal value, but breathing adequacy still requires clinical assessment.
Use the stable-signal 93% reading from the approved alternate site, and continue clinical breathing assessment because a validated oxygenation measurement does not establish adequate ventilation in this confused patient with shallow breaths.
Question 70
An adult has new wheezing and dyspnea. You know the onset time, allergies, and medication list; breathing support is underway. Which TWO missing history details most directly help assess the current respiratory episode and response to prior care?
Select exactly 2 answers.
☐ A. Whether a usual trigger, recent fever, or cough preceded this episode.
☐ B. Whether a similar episode required hospital admission several years ago.
☐ C. How many years the patient has used the listed daily preventive respiratory medicine.
☐ D. Which respiratory treatment was used today and how symptoms changed afterward.
☐ E. How far the patient could usually walk without dyspnea before this illness.
Show answer and explanation
Response:A, D
Final answer:A. Whether a usual trigger, recent fever, or cough preceded this episode.; D. Which respiratory treatment was used today and how symptoms changed afterward.
A asks about precipitating or associated symptoms, and D establishes what respiratory treatment was actually used today and its effect. Those are the requested gaps. Prior admission, preventive-treatment duration and baseline walking tolerance add useful background but do not answer these two acute-episode targets.
Question 71
After abdominal trauma, an adult is pale and confused with weak pulses but effective breathing. No major external bleeding is found. Rapid transport and an on-route ALS request are already arranged. Which immediate care plan best matches the circulation concern while departure proceeds?
☐ A. Limit heat loss, continue ABC and perfusion reassessment, and support indicated oxygenation needs.
☐ B. Provide assisted breaths at a fixed rapid rate because every confused trauma patient is ventilating inadequately.
☐ C. Prioritize a complete abdominal examination at the scene to identify the organ before continuing the care plan.
☐ D. Use cool wet coverings to prevent the pulse from increasing while the patient is moved.
Show answer and explanation
Response:A
Final answer:A. Limit heat loss, continue ABC and perfusion reassessment, and support indicated oxygenation needs.
Conserve warmth, support oxygenation as indicated and continue ABC/perfusion reassessment during the arranged transport for possible occult shock, while avoiding automatic rapid bagging in a patient whose effective breathing does not establish a need for assisted ventilation.
Question 72
An unstable patient needs rapid transport. The nearest appropriate hospital is 8 minutes away. An ALS unit would reach the scene in 15 minutes, but another ALS unit can meet your ambulance on the direct route in 4 minutes. The supplied policy allows intercept only without delaying hospital arrival. Which plan follows it?
☐ A. Request the scene unit and keep the patient on scene until its estimated arrival in 15 minutes.
☐ B. Depart toward the hospital but turn back after four minutes to meet the unit approaching the original scene.
☐ C. Depart with support and coordinate the unit that can meet the direct route in four minutes.
☐ D. Remain on scene until the direct-route unit reports that it has reached its four-minute meeting point.
Show answer and explanation
Response:C
Final answer:C. Depart with support and coordinate the unit that can meet the direct route in four minutes.
Coordinate the four-minute direct-route intercept while leaving for the hospital with support continuing. Waiting adds scene time. The other unit's 15-minute estimate refers to the scene, and returning toward it cannot preserve the stated eight-minute direct hospital trip.
Question 73
During bag-mask ventilation, air escapes around the adult patient's mask and chest rise is poor. Two trained rescuers are available. Which adjustment directly addresses the likely problem?
☐ A. Deliver a larger tidal volume through the same leaking mask until chest rise appears.
☐ B. Shorten the interval between breaths while leaving airway position and seal unchanged.
☐ C. Change the oxygen source before addressing the visibly leaking patient interface.
☐ D. Use one rescuer for a two-handed seal and airway position while the second squeezes the bag.
Show answer and explanation
Response:D
Final answer:D. Use one rescuer for a two-handed seal and airway position while the second squeezes the bag.
Use two-rescuer ventilation to correct the observed interface leak: one maintains airway position and a two-handed seal while the other delivers breaths. Verify chest rise. Increasing flow, rate or bag volume through the same faulty seal leaves the demonstrated problem unresolved.
Question 74
The scene is secure. An anxious, agitated patient can hear and respond to you. Mark each approach S = supportive de-escalation or E = likely to escalate the interaction. No immediate threat requires physical intervention.
Codes: S: Supportive; E: Escalating
Finding or action
Code
A.
Use one calm speaker and allow space between the responder and patient.
B.
Offer a choice between two safe assessment positions without rushing the response.
C.
Have several responders stand close to reassure the patient, speaking over each other.
D.
Repeat multiple rapid questions when the patient hesitates, moving closer to obtain an answer.
Show answer and explanation
Response:A=S; B=S; C=E; D=E
Final answer:A=S; B=S; C=E; D=E
One calm speaker, room for a reply and a limited safe choice support de-escalation by reducing pressure on the patient, while crowding, competing voices and faster questions after hesitation add stimulation even when the responders intend to offer reassurance.
Question 75
The supplied AED guide says a red service indicator after the specified self-test means the device must be removed from service. The battery shows full charge, but the service indicator remains red after that test. What should you do?
☐ A. Run the normal pad-connection check and return the AED to service if the battery still reads full.
☐ B. Remove the AED from service and arrange a replacement that passes its checks.
☐ C. Record the red result but leave the AED ready for clinical use because it completed a self-test.
☐ D. Charge the battery again and clear the log without verifying that the service fault is resolved.
Show answer and explanation
Response:B
Final answer:B. Remove the AED from service and arrange a replacement that passes its checks.
Remove the AED from service and obtain a verified replacement as the printed fault guide directs. The red indicator persists. A charged battery and a completed self-test do not mean that this device has passed the required functional check.
Question 76
An adult has chronic left-leg weakness. Family now reports abrupt slurred speech and new right-arm weakness; the patient was at the usual baseline 15 minutes ago. What is the most appropriate general impression?
☐ A. An expected fluctuation in the old left-leg weakness because the patient has a known disability.
☐ B. A new time-critical neurologic event because the right-arm and speech changes differ from baseline.
☐ C. A nonurgent recurrent deficit because the patient was at baseline only 15 minutes ago.
☐ D. A baseline communication difficulty to resolve by reviewing old records before current assessment.
Show answer and explanation
Response:B
Final answer:B. A new time-critical neurologic event because the right-arm and speech changes differ from baseline.
The new right-arm weakness and slurred speech differ from the established left-leg deficit. Treat that abrupt change as time-critical. The family's recent normal observation clarifies the baseline and should prompt acute neurological assessment instead of a delay for old records.
Question 77
An adult with chest discomfort has a weak pulse, cool skin, and blood pressure of 78/50 mmHg. Your authorized protocol does not permit nitroglycerin at this pressure. Which care plan is appropriate?
☐ A. Support ABCs and perfusion, arrange urgent transport, and request advanced assistance.
☐ B. Use a routine transport plan because the patient is still conscious.
☐ C. Repeat the blood pressure at the scene until it normalizes before deciding on transport.
☐ D. Assist with the prescribed nitroglycerin, then reassess pressure because chest discomfort is the priority.
Show answer and explanation
Response:A
Final answer:A. Support ABCs and perfusion, arrange urgent transport, and request advanced assistance.
Continue basic shock support with urgent transport and advanced assistance for the hypotensive chest-pain patient. Nitroglycerin is prohibited here. The supplied pressure restriction governs the medication decision while poor perfusion demands care rather than repeated on-scene measurements until the number normalizes.
Question 78
A confused adult has an alcohol odor, a small forehead bruise after a possible fall, and a history of diabetes. ABC support is underway. Which THREE assessments address plausible reversible or dangerous contributors rather than assuming alcohol is the only cause?
Select exactly 3 answers.
☐ A. Examine for head injury and clarify the reported fall.
☐ B. Reassess oxygenation, ventilation, and vital-sign trends.
☐ C. Estimate intoxication severity from the alcohol odor before evaluating the bruise.
☐ D. Use orientation answers alone to decide whether a metabolic measurement is needed.
☐ E. Obtain an authorized blood-glucose measurement.
☐ F. Treat the presence of a diabetes medication list as a substitute for measuring glucose.
Show answer and explanation
Response:A, B, E
Final answer:A. Examine for head injury and clarify the reported fall.; B. Reassess oxygenation, ventilation, and vital-sign trends.; E. Obtain an authorized blood-glucose measurement.
Assess the fall and head injury, measure authorized glucose, and reassess breathing and circulation. Several causes may coexist. Alcohol odor cannot explain away trauma or metabolic illness, and an orientation reply or medication list does not replace those physiological checks.
Question 79
For this question, P = an immediate airway, breathing, or perfusion threat; S = a finding for secondary assessment when no immediate ABC threat is present. Classify each independent pediatric finding.
Codes: P: Primary threat; S: Secondary finding
Proposal
P
S
A.
Poor chest rise with shallow breaths and reduced responsiveness.
B.
Ankle tenderness with warm skin, normal pulses, and normal breathing.
C.
Stridor with marked effort and little air movement.
D.
A painful closed forearm deformity with warm fingers, palpable pulse, and effective breathing.
Show answer and explanation
Response:A=P; B=S; C=P; D=S
Final answer:A=P; B=S; C=P; D=S
Poor chest rise with reduced responsiveness and stridor with restricted airflow belong in the primary-threat category, leaving the perfused ankle and forearm injuries for secondary assessment and treatment once immediate support permits, which assigns P, S, P, S.
Question 80
Dispatch reports a rollover van carrying a school activity group. The first caller mentions one injured adult but does not know the passenger count. Which prearrival action best improves resource planning?
☐ A. Assign final immediate triage to every reported occupant before the crew sees the crash.
☐ B. Request only one ambulance until individual histories identify all injured people.
☐ C. Treat the one named injury as the confirmed total, using the van's capacity only for towing needs.
☐ D. Clarify actual occupancy and coordinate resources for the possible additional patients.
Show answer and explanation
Response:D
Final answer:D. Clarify actual occupancy and coordinate resources for the possible additional patients.
Clarify the school group's occupancy and coordinate provisional resources before arrival. One reported injury is not a tally. Patient findings at the scene must determine individual triage, while dispatch information can already guide preparation for a potentially larger incident.
Question 81
The supplied inventory rule counts only unopened, intact dressing packs stored in the clean compartment. One valid pack contains two dressings. The unit needs six dressings: two valid packs are in clean storage, one intact pack is in the contaminated-return bin, and one opened pack is in clean storage. How many additional valid packs must be placed in clean storage to meet the rule?
☐ A. One pack.
☐ B. No packs, because eight physical dressings are present.
☐ C. Two packs, one for each dressing missing from the six-dressing minimum.
☐ D. Three packs, to replace both excluded packs and cover the remaining two-dressing deficit.
Show answer and explanation
Response:A
Final answer:A. One pack.
Two qualifying clean packs supply four dressings, leaving a deficit of two under the six-dressing minimum. Add one intact two-dressing pack. The opened and contaminated-return packs remain excluded under the stated storage and packaging rule.
Question 82
An unresponsive adult after a fall has a definite pulse and inadequate breathing. Manual spinal support is maintained. Jaw thrust has failed; an appropriately fitted and tolerated oral adjunct also has not opened the airway. No removable obstruction is visible. Which next maneuver is appropriate?
☐ A. Maintain the same jaw thrust and defer breaths until a collar is fitted.
☐ B. Increase oxygen flow through the mask without changing the ineffective airway position.
☐ C. Wait for an advanced airway because further basic positioning is contraindicated after trauma.
☐ D. Use head tilt--chin lift as needed to open the airway and establish effective ventilation.
Show answer and explanation
Response:D
Final answer:D. Use head tilt--chin lift as needed to open the airway and establish effective ventilation.
After jaw thrust and a properly fitted tolerated adjunct both fail, use the necessary head tilt--chin lift while maintaining practical spinal support. Ventilation still has to be established. Check chest rise after the maneuver rather than delaying for collar completion or an advanced crew.
Question 83
The following are independent patients with an indicated spinal motion-restriction plan. Mark each proposal Y = appropriate or N = inappropriate for the stated findings. Airway and breathing remain under assessment.
Codes: Y: Appropriate; N: Inappropriate
Proposal
Y
N
A.
An older adult has fixed spinal curvature: support the usual contour with padding instead of forcing flat alignment.
B.
A child develops new neck pressure after collar placement: finish the planned transfer before checking fit because the collar was sized correctly.
C.
During gentle movement toward neutral alignment, the patient reports increasing neck pain: continue through a small additional range to improve device fit.
D.
After positioning and securement, reassess breathing, comfort, and alignment.
Show answer and explanation
Response:A=Y; B=N; C=N; D=Y
Final answer:A=Y; B=N; C=N; D=Y
Support the fixed spinal contour and reassess after securement, making A and D appropriate. New collar discomfort requires fit assessment. Continuing even a small alignment movement through increasing pain, or deferring a new pressure problem until after transfer, does not meet patient-specific motion-restriction care.
Question 84
After suction and assisted ventilation, an adult's chest rise becomes visible and the pulse-ox signal stabilizes at 95%. The patient remains unable to follow commands, and spontaneous breaths are only 4/min. Which conclusion best fits reassessment?
☐ A. Airway clearance must still be ineffective because the patient has not regained command following.
☐ B. Air movement improved with support, but four spontaneous breaths per minute still require assistance.
☐ C. Increase bagging rate until the patient follows commands, regardless of the achieved chest rise.
☐ D. Stop assisted breaths for a prolonged trial because the supported saturation has reached 95%.
Show answer and explanation
Response:B
Final answer:B. Air movement improved with support, but four spontaneous breaths per minute still require assistance.
Continue effective assistance and reassessment because the improved chest rise and stable saturation occurred during supported ventilation, whereas the patient's independent rate remains only four breaths per minute and supplies no evidence that adequate breathing will persist when that help is withdrawn.
Question 85
A patient with COPD initially breathes rapidly with wheezing. During assessment, the wheezing becomes faint, chest movement decreases, and the patient becomes drowsy. Supplemental oxygen is already in place. What does the quieter breathing most likely mean?
☐ A. Oxygen toxicity is established, requiring removal of oxygen before assessing air movement.
☐ B. The drowsiness and reduced chest movement are adequately explained by the COPD history.
☐ C. Resolved bronchospasm is the best interpretation of faint wheezing despite the reduced effort.
☐ D. Airflow may be failing with fatigue; promptly assess the need for assisted ventilation.
Show answer and explanation
Response:D
Final answer:D. Airflow may be failing with fatigue; promptly assess the need for assisted ventilation.
Quieter wheezing with less chest movement and increasing drowsiness can mean diminished airflow and exhaustion. Assess the need for ventilatory assistance. This combined trend warrants concern even when oxygen is running, rather than assuming the wheeze has resolved from its sound alone.
Question 86
A chemical-exposure patient arrives at the controlled exit wearing visibly contaminated outer clothing. The patient can breathe adequately, and a trained decontamination team is ready. What should happen before routine clean-ambulance transport?
☐ A. Wrap the contaminated clothing in an ordinary sheet and load before consulting the decontamination team.
☐ B. Coordinate the required clean-side decontamination and communicate the exposure before routine loading.
☐ C. Move the breathing-stable patient into the clean ambulance so decontamination can be completed en route.
☐ D. Begin the hospital journey after removing visible surface material yourself without the trained team's clearance.
Show answer and explanation
Response:B
Final answer:B. Coordinate the required clean-side decontamination and communicate the exposure before routine loading.
Coordinate the available trained decontamination process before loading this adequately breathing patient into the clean ambulance. Communicate the exposure. Clothing wrap or superficial wiping cannot establish clearance of contamination, so the receiving transport team needs the qualified clean-side handoff.
Question 87
An alert patient rescued from cold weather has severe, ongoing extremity bleeding and cool skin. Breathing is effective, with a reliable room-air saturation of 97%. Which TWO immediate actions address the stated circulation risks while preparing prompt transport?
Select exactly 2 answers.
☐ A. Use dry insulation and appropriate warming to limit additional heat loss.
☐ B. Obtain a complete secondary examination before bleeding control if the first systolic pressure is within the reference range.
☐ C. Start assisted breaths to prevent later shock-related respiratory failure despite currently effective breathing.
☐ D. Prioritize high-flow oxygen for the cool skin before controlling the bleeding or providing thermal protection.
☐ E. Use authorized measures to stop the life-threatening bleeding and verify control.
Show answer and explanation
Response:A, E
Final answer:A. Use dry insulation and appropriate warming to limit additional heat loss.; E. Use authorized measures to stop the life-threatening bleeding and verify control.
Dry insulation and appropriate warming limit additional cooling while authorized control stops the ongoing severe bleeding, addressing the two identified circulation risks without deferring care for a secondary examination on the basis of a temporarily preserved pressure or bagging a patient who already breathes effectively.
Question 88
Medical direction says to split one dose from the supplied single-dose nasal device between both nostrils. Its verified instructions require the whole device in one nostril, and your written protocol uses that device exactly as labeled. What should you do before administration?
☐ A. Split the device as ordered even though it cannot be metered accurately.
☐ B. Use a different route without asking because the medicine name is the same.
☐ C. Explain the mismatch and obtain clarification of the order and device.
☐ D. Give it in one nostril without notifying medical direction of the discrepancy.
Show answer and explanation
Response:C
Final answer:C. Explain the mismatch and obtain clarification of the order and device.
Communicate the device/order discrepancy to medical direction and obtain clarification before administration. This device delivers one whole dose. An unmetered split, a route substitution or a silent change to the order cannot resolve the explicitly verified conflict with the available product and protocol.
Question 89
After convulsions stop, an adult has a definite pulse but shallow breathing at 4/min and gurgling in the mouth. Which care priority is most appropriate?
☐ A. Give oxygen by mask and prioritize the postictal neurologic examination before suction.
☐ B. Clear the gurgling airway and provide assisted breaths that produce effective chest rise.
☐ C. Use recovery positioning and observe without ventilation while waiting for spontaneous recovery.
☐ D. Start compressions because the slow respiratory rate indicates seizure-related cardiac arrest.
Show answer and explanation
Response:B
Final answer:B. Clear the gurgling airway and provide assisted breaths that produce effective chest rise.
Clear the gurgling material and assist the four shallow breaths per minute in this patient with a definite pulse, continuing seizure history and neurological assessment as care permits rather than allowing a postictal appearance to postpone treatment of actual airway obstruction and inadequate ventilation.
Question 90
The supplied report-amendment workflow requires opening the locked report without altering its original text; then adding a separately dated correction; then signing the correction; then submitting it through the audit-trail process. Order the FOUR action packets.
A.
Submit the amendment through the tracked agency process.
B.
Authenticate the correction with the required signature.
C.
Open the existing report in amendment mode, preserving the original entry.
D.
Enter the correction with its date and time and identify what it corrects.
Order: 1. 2. 3. 4.
Show answer and explanation
Response:C D B A
Final answer:C D B A
Open amendment mode preserving the original, enter the dated correction, authenticate it and submit through the tracked workflow. The original remains intact. These supplied dependencies make C, D, B, A the auditable sequence for correcting the report.
Question 91
Several people inside a workshop report dizziness and breathing discomfort. No unusual odor is noticed, but the ventilation system has failed. The atmosphere has not been assessed. Which scene decision is appropriate?
☐ A. Stage safely and request qualified atmospheric hazard assessment before exposing responders.
☐ B. Enter after opening a door, treating visible air movement as proof of atmospheric safety.
☐ C. Treat the absence of an unusual smell as a sufficient initial gas assessment.
☐ D. Send a worker wearing a surgical mask to retrieve the patients while the crew stages.
Show answer and explanation
Response:A
Final answer:A. Stage safely and request qualified atmospheric hazard assessment before exposing responders.
Stage clear and request qualified atmospheric assessment when several occupants become symptomatic after the ventilation failure. Lack of odor is insufficient. Neither an open doorway nor a surgical mask establishes safe access to an atmosphere that has not been tested or controlled.
Question 92
After caring for one patient, you are moving to another patient. Your disposable gloves appear clean. Which action is appropriate?
☐ A. Apply hand sanitizer to the gloves and reuse them.
☐ B. Change gloves only after both patients have been transported.
☐ C. Use the same gloves if no blood is visible.
☐ D. Remove the gloves, perform hand hygiene, and use new gloves when indicated for the next patient.
Show answer and explanation
Response:D
Final answer:D. Remove the gloves, perform hand hygiene, and use new gloves when indicated for the next patient.
Remove the first patient's disposable gloves, perform hand hygiene and use new gloves when indicated for the next patient. Contamination may be invisible. Sanitizing or visually inspecting disposable gloves cannot establish that they are suitable for patient-to-patient reuse.
Question 93
Your stated agency authorization permits an EMT to obtain glucose, use pulse oximetry, and acquire and transmit a 12-lead ECG. It does not permit independent ECG interpretation. Which action stays within that authorization?
☐ A. Acquire and transmit the ECG with current symptoms and vital signs for qualified interpretation.
☐ B. Label the exact infarct location before transmission because acquiring the tracing includes interpretation permission.
☐ C. Delay transmitting an adequate tracing until an EMT independently excludes every diagnostic artifact.
☐ D. Provide a definitive rhythm diagnosis to the patient without sending the tracing for qualified interpretation.
Show answer and explanation
Response:A
Final answer:A. Acquire and transmit the ECG with current symptoms and vital signs for qualified interpretation.
Acquire the authorized tracing and transmit it with relevant clinical observations for qualified interpretation. Acquisition permission is limited. It does not grant an independent definitive rhythm or infarct diagnosis, and such a diagnosis is unnecessary before this approved transmission.
Question 94
For each newborn, select I = initial supportive care and continued assessment or V = begin assisted ventilation promptly. Use the stated findings after any initial steps already described; categories may repeat.
Codes: I: Initial care/assessment; V: Assisted ventilation
Finding or action
Code
A.
Strong cry, good tone, and heart rate 140/min immediately after birth.
B.
Apnea after warming, drying, positioning, and brief stimulation; heart rate 110/min.
C.
Weak breathing and heart rate 80/min despite completed initial steps.
D.
Effective spontaneous breathing, good tone, and heart rate 130/min after drying.
Show answer and explanation
Response:A=I; B=V; C=V; D=I
Final answer:A=I; B=V; C=V; D=I
Give ventilation to both newborns with persistent inadequate breathing after the initial steps, including the apneic infant whose heart rate is 110. Apnea alone is sufficient. Strong crying or effective breathing with good tone supports continued initial care for the other two newborns.
Question 95
An unstable trauma patient has worsening perfusion after abdominal injury. The supplied regional rule directs patients needing emergency trauma surgery to a capable trauma hospital unless travel exceeds 30 minutes. Hospital A is 8 minutes away but cannot provide that service; Hospital B is a capable trauma hospital 22 minutes away. BLS support is underway. Which destination plan follows this rule?
☐ A. Take A because any eight-minute destination outranks a hospital with greater capability.
☐ B. Transport to B with continued support, because it supplies the required capability within the stated travel limit.
☐ C. Take A first, then arrange transfer after its team confirms the exact injury.
☐ D. Stay for a definitive abdominal diagnosis before applying the regional destination rule.
Show answer and explanation
Response:B
Final answer:B. Transport to B with continued support, because it supplies the required capability within the stated travel limit.
Choose hospital B because its 22-minute journey remains within the supplied 30-minute exception and it provides the required service, unlike the closer eight-minute hospital whose lack of capability would make an initial stop inconsistent with this explicit destination rule.
Question 96
After a pesticide exposure, decontamination is complete and ABCs are stable. You have the product name but not its concentration or the exposure duration. The contaminated container remains in the controlled area. Which action best improves the focused history safely?
☐ A. Obtain concentration and exposure duration by clean-side communication, keeping the contaminated container outside the ambulance.
☐ B. Use the product name alone because concentration does not change exposure risk.
☐ C. Bring the container in a routine patient-property bag without qualified decontamination confirmation.
☐ D. Return the stable patient to the controlled area to read the label personally.
Show answer and explanation
Response:A
Final answer:A. Obtain concentration and exposure duration by clean-side communication, keeping the contaminated container outside the ambulance.
Obtain concentration and exposure-duration information through a clean-side exchange after decontamination and stabilization. The concentration is still missing. Do not bring an uncleared container into the ambulance or return the patient to the hazard merely to complete the history.
Question 97
A securely controlled scene patient remains agitated during transport preparation. The authorized plan calls for safe securement and continuous monitoring. Which arrangement is appropriate?
☐ A. Use approved semi-reclined securement and a continuous saturation display, with direct airway checks only if the display changes.
☐ B. Use approved lateral securement, checking breathing whenever the patient reports discomfort.
☐ C. Use approved securement that preserves breathing and permits continued airway and clinical assessment.
☐ D. Use approved semi-reclined securement and check breathing during loading, then repeat the examination only at hospital handoff.
Show answer and explanation
Response:C
Final answer:C. Use approved securement that preserves breathing and permits continued airway and clinical assessment.
Use approved securement with unrestricted breathing and continued direct airway and clinical assessment. A suitable position alone is insufficient. Pulse-ox-only observation, waiting for a complaint and checking only at handoff each leave gaps in the required monitoring of this agitated patient.
Question 98
An adult who may have impaired understanding refuses transport after a head injury. ABCs are currently stable, but the patient cannot clearly explain the possible consequences of leaving. Which THREE actions support an appropriate assessment and communication process?
Select exactly 3 answers.
☐ A. Use medical direction and the applicable capacity/refusal process when understanding remains uncertain.
☐ B. Ask the patient to explain the recommended care and consequences in the patient's own words.
☐ C. Accept an orientation-to-name answer as a complete decision-making-capacity assessment.
☐ D. Ask a family member to sign instead of evaluating the patient's understanding.
☐ E. Use a signed refusal form as the sole confirmation that the patient understood the consequences.
☐ F. Explain the specific concern and recommendation in clear, manageable language.
Show answer and explanation
Response:A, B, F
Final answer:A. Use medical direction and the applicable capacity/refusal process when understanding remains uncertain.; B. Ask the patient to explain the recommended care and consequences in the patient's own words.; F. Explain the specific concern and recommendation in clear, manageable language.
Explain the head-injury concern clearly, ask the patient to teach it back and use medical direction and the applicable refusal process if capacity remains uncertain. A signature cannot settle capacity. Neither a name-orientation answer nor a relative's signature establishes the patient's understanding and appreciation.
Question 99
A supervisor's roster lists eight workers in an affected room. The accountability sheet has eight entries, but one name appears twice, leaving seven distinct people identified. A witness last saw the unlisted worker move toward an uncleared storage area. What should you report to command?
☐ A. The sheet total is eight, so the roster is reconciled and no search concern remains.
☐ B. The witness saw the worker walking, so that worker can be entered as currently safe.
☐ C. One possible missing worker and the last reported location, with the duplicate tally noted.
☐ D. A confirmed critical eighth patient requiring immediate clinical triage despite not being located.
Show answer and explanation
Response:C
Final answer:C. One possible missing worker and the last reported location, with the duplicate tally noted.
The duplicate leaves seven distinct workers accounted for against a roster of eight. Report the unresolved identity and last-known-location evidence for a qualified safe search, since an earlier walking sighting establishes neither current safety nor the missing person's present clinical condition.
Question 100
Three weeks after a distressing call, an EMT reports intrusive memories, poor sleep, and difficulty functioning at work and home. Which response is most appropriate?
☐ A. Offer a private peer-support meeting and revisit the need for professional help only if the symptoms become more severe.
☐ B. Offer support and encourage confidential professional help because symptoms are interfering with daily function.
☐ C. Recommend rest and temporary lighter duties as the complete response, with professional help reserved for failure to resume full shifts.
☐ D. Suggest independent journaling and relaxation first, using the EMT's ability to complete calls as the reason to postpone professional resources.
Show answer and explanation
Response:B
Final answer:B. Offer support and encourage confidential professional help because symptoms are interfering with daily function.
Confidential professional help is appropriate because three weeks of symptoms are already impairing work and home life, with peer contact, rest and journaling available as additional supports rather than using deterioration or failure to complete full shifts as a prerequisite for referral.
Question 101
A four-year-old with vomiting is unusually quiet, has mottled skin and weak peripheral pulses, and barely reacts when a caregiver approaches. The caregiver says the child normally talks and reaches for comfort. A single blood-pressure reading is within the supplied age reference range. What is the best interpretation?
☐ A. A normal-pressure child with a minor gastrointestinal illness, because hypotension is absent.
☐ B. Improved comfort after vomiting, because the child has become quiet.
☐ C. A baseline behavioral difference until a measurement falls outside the age reference range.
☐ D. A potentially serious pediatric illness based on abnormal interaction and perfusion despite the single pressure.
Show answer and explanation
Response:D
Final answer:D. A potentially serious pediatric illness based on abnormal interaction and perfusion despite the single pressure.
The caregiver describes a loss of usual interaction alongside mottling and weak pulses. These are concerning findings. Pediatric compensation can preserve one reference-range pressure during serious illness, so the apparently normal number cannot erase the abnormal appearance and perfusion assessment.
Question 102
An adult initially breathed 5/min. Assisted breaths improved chest rise; then vomiting interrupted ventilation, requiring suction. After clearance, assisted breaths again produced chest rise, but spontaneous breathing remains 5/min. Which receiving-team report accurately represents that sequence and current support need?
☐ A. Initial 5/min breathing; assisted rise improved, vomiting required suction, assisted rise returned, and ventilatory support is still required.
☐ B. Initial 5/min breathing; suction restored spontaneous ventilation, vomiting followed, and continued assisted breaths are precautionary.
☐ C. Initial vomiting; 5/min breathing resolved with suction alone, assisted breaths improved comfort, and independent ventilation is now adequate.
☐ D. Initial 5/min breathing; vomiting improved the airway, suction ended the episode, and assisted breathing can stop at handoff.
Show answer and explanation
Response:A
Final answer:A. Initial 5/min breathing; assisted rise improved, vomiting required suction, assisted rise returned, and ventilatory support is still required.
A preserves the actual chronology: slow spontaneous breathing, effective assisted rise, vomiting, suction and restored assisted rise. Independent breathing stays at 5/min. That final distinction communicates why ventilation support remains necessary during transfer despite removal of the obstruction.
Question 103
A tourniquet was applied for severe extremity bleeding at 14:22, and bleeding was confirmed stopped at 14:23. The patient now reports pain beneath it, but control remains effective. Which plan is appropriate during transfer of care?
☐ A. Maintain the effective device, reassess control, and report its location and the known 14:22 application time.
☐ B. Convert to a pressure dressing before handoff because painful tourniquet pressure means the device is too tight.
☐ C. Use the receiving team's arrival time as the application time to simplify transfer documentation.
☐ D. Enter 14:23 in the application-time field because confirmed bleeding control defines the application time.
Show answer and explanation
Response:A
Final answer:A. Maintain the effective device, reassess control, and report its location and the known 14:22 application time.
Maintain verified bleeding control and report the actual 14:22 application time and location at handoff. Discomfort warrants assessment. It does not justify releasing an effective tourniquet, and neither the later confirmation of control nor arrival time can substitute for the known application time.
Question 104
The initial AVPU finding was V: the patient opened eyes and followed a request only when spoken to. Each row is an independent later observation. Mark W = worse responsiveness or N = not worse than that initial state.
Codes: W: Worse; N: Not worse
Proposal
W
N
A.
Eyes now open spontaneously; the patient speaks appropriately without prompting.
B.
No response to speech; the patient withdraws only to an appropriate painful stimulus.
C.
Still opens eyes and follows the same request when spoken to.
D.
No response to either speech or an appropriate painful stimulus.
Show answer and explanation
Response:A=N; B=W; C=N; D=W
Final answer:A=N; B=W; C=N; D=W
Relative to the initial voice-dependent response, alert interaction is better, the same verbal response is unchanged, and pain-only or absent response is worse. The earlier response required speech. Movement in itself cannot be assigned an alert level without the stated interaction evidence.
Question 105
Command supplies this rule for the only available ambulance: transport the I patient first; I requires immediate breathing support or uncontrolled major bleeding, while D is nonwalking without either. Patient 1 cannot walk but breathes normally and has controlled bleeding. Patient 2 needs assisted ventilation. Patient 3 can walk and has a minor cut. Which patient has priority under this rule?
☐ A. All three, because inability to walk and need for ventilation receive the same category.
☐ B. Patient 3, because a minor cut permits the fastest definitive treatment.
☐ C. Patient 2, because assisted ventilation meets the immediate-support criterion.
☐ D. Patient 1, because a painful nonwalking injury always outranks a respiratory intervention.
Show answer and explanation
Response:C
Final answer:C. Patient 2, because assisted ventilation meets the immediate-support criterion.
Patient 2 needs assisted ventilation and therefore meets the supplied I criterion for first transport. The nonwalking perfused patient is D. Pain and inability to walk still require care, but they do not outrank the specific immediate breathing threat under this rule.
Question 106
An adult with a confirmed total laryngectomy has a definite pulse and inadequate breathing. The stoma is patent. In the diagram, A is the upper face and B is the permanent neck opening. Which interface should be used to deliver bag-mask breaths to the lungs?
☐ A. A, with B sealed during each delivered breath.
☐ B. A, after inserting a properly sized oral airway.
☐ C. A, with the nose pinched to prevent an upper-face leak.
☐ D. B, using an appropriately sized small mask to make a seal.
Show answer and explanation
Response:D
Final answer:D. B, using an appropriately sized small mask to make a seal.
The labeled neck stoma B connects to the lungs after total laryngectomy. Seal a suitable small mask there. The upper-face route is surgically disconnected, so an oral adjunct or a better face seal cannot provide breaths through that absent connection.
Question 107
A supplied guide requires the AED to show READY after self-test and the oximeter setup to produce a stable simulator signal. The AED shows SERVICE. Oximeter 1 fails with probe X but passes with probe Y; probe X also fails on a working spare monitor. Which TWO conclusions are supported?
Select exactly 2 answers.
☐ A. Probe X is the demonstrated oximeter fault; a working complete setup still needs verification before service.
☐ B. Oximeter 1 must be discarded because any failure with a probe proves a monitor fault.
☐ C. The AED has failed its stated readiness criterion and needs the prescribed service or replacement process.
☐ D. The AED is ready if the oximeter's replacement-probe test passes.
☐ E. Probe X can be counted as working because two different monitors gave the same failed result.
Show answer and explanation
Response:A, C
Final answer:A. Probe X is the demonstrated oximeter fault; a working complete setup still needs verification before service.; C. The AED has failed its stated readiness criterion and needs the prescribed service or replacement process.
Probe X fails on both monitors while Y works on monitor 1, locating the demonstrated oximeter fault in X. The AED also fails READY. Resolve those separate faults according to the supplied guides and verify usable assembled equipment before returning either setup to service.
Question 108
A newly born infant remains apneic after warming, drying, positioning, and brief stimulation. Heart rate is 80/min. You are equipped and authorized to provide neonatal bag-mask ventilation. Which next action is appropriate under current guidance?
☐ A. Observe without intervention because 80/min is adequate immediately after birth.
☐ B. Begin compressions first because any heart rate below 100/min requires them.
☐ C. Begin assisted ventilation promptly at 30--60 inflations/min and assess effectiveness.
☐ D. Continue stimulation for several minutes before attempting ventilation.
Show answer and explanation
Response:C
Final answer:C. Begin assisted ventilation promptly at 30--60 inflations/min and assess effectiveness.
Start assisted newborn ventilation at 30--60 inflations per minute when the completed initial steps leave apnea and a heart rate of 80, checking chest movement and a rising heart rate for effectiveness before considering compressions under their separate postventilation threshold.
Question 109
After blunt chest trauma, an adult develops increasing dyspnea, markedly diminished breath sounds on the left, and falling blood pressure. No external bleeding explains the decline. Which complication is most concerning from this combination?
☐ A. Cardiogenic pulmonary edema.
☐ B. Hemorrhagic shock from intra-abdominal bleeding.
☐ C. Tension pneumothorax.
☐ D. Pulmonary contusion.
Show answer and explanation
Response:C
Final answer:C. Tension pneumothorax.
Marked left-sided loss of air entry with progressive dyspnea and hypotension after blunt trauma raises concern for tension pneumothorax because both breathing and perfusion are deteriorating. Blood pressure is falling. Pulmonary contusion and internal bleeding remain possible, but this particular combination calls for urgent advanced help and transport with EMT support rather than an unauthorized decompression procedure.
Question 110
A supplied command workflow requires reporting a suspected hazardous access problem from a safe location before rescue assignment. Only the assigned rescue team may obtain and report access clearance. Ordinary EMT entry follows that clearance. Order the FOUR packets; the scene begins uncleared.
A.
Stage safely and report the location and suspected access hazard to command.
B.
Receive the assigned team's confirmation that the access route is safe.
C.
Request and receive assignment of the qualified rescue resource through command.
D.
Enter by the cleared route and begin patient assessment.
Order: 1. 2. 3. 4.
Show answer and explanation
Response:A C B D
Final answer:A C B D
Report from a safe location so command can assign qualified rescue resources, obtain clearance and then permit ordinary EMT entry. The scene starts uncleared. Medical PPE does not replace the specific hazard-control steps that make A, C, B, D the required access sequence.
Question 111
After blunt abdominal trauma, a patient initially answers normally with pulse 104/min and pressure 116/78 mmHg. Ten minutes later, the patient is confused, pulse is 132/min, pressure is 92/70, and abdominal tenderness has increased. A small forearm cut remains dry. Which interpretation best fits the trend?
☐ A. A mainly vasovagal episode, because abdominal pain can cause a transient pressure fall.
☐ B. Worsening hypoperfusion with internal hemorrhage among the major concerns.
☐ C. Isolated musculoskeletal pain, because the only visible wound remains dry.
☐ D. Improving circulation with compensatory tachycardia sufficient to offset the falling pressure.
Show answer and explanation
Response:B
Final answer:B. Worsening hypoperfusion with internal hemorrhage among the major concerns.
Rising pulse, falling pressure, new confusion and increasing abdominal tenderness suggest worsening perfusion with possible internal hemorrhage. The minor forearm wound is dry. Its appearance cannot explain or exclude the deeper blood-loss concern, and tachycardia alone cannot prove successful compensation.
Question 112
An eight-year-old with anaphylaxis initially improved after an authorized epinephrine autoinjector. During transport preparation, wheezing returns and the child becomes pale and less responsive. What should the crew do?
☐ A. Use the first treatment response to classify the return of wheezing as a routine observation issue.
☐ B. Repeat a larger-than-authorized dose because recurrent symptoms establish that the first device was inadequate.
☐ C. Prioritize completing the exposure history before reassessing the returning breathing and perfusion changes.
☐ D. Reassess ABCs and obtain further authorized treatment and help while urgent transport proceeds.
Show answer and explanation
Response:D
Final answer:D. Reassess ABCs and obtain further authorized treatment and help while urgent transport proceeds.
Reassess ABCs immediately and pursue further authorized care and advanced assistance while urgent transport continues. The response did not last. Returning wheeze, pallor and declining interaction cannot be managed as routine improvement or used to invent a larger epinephrine dose.
Question 113
These are FOUR independent adult patients. Choose the immediate circulation-care pathway: C = CPR; B = control severe external bleeding; S = shock support and rapid transport. Breathing is adequate in every patient with a pulse, and only the stated source has major bleeding.
Codes: C: CPR; B: Bleeding control; S: Shock support/transport
Finding or action
Code
A.
Unresponsive, not breathing normally, and no definite pulse within 10 seconds.
B.
Definite pulse and rapid uncontrolled bleeding from a thigh wound.
C.
Definite pulse, cool skin, weak circulation, and no external bleeding after abdominal trauma.
D.
Definite pulse and severe forearm bleeding while direct pressure is ineffective.
Show answer and explanation
Response:A=C; B=B; C=S; D=B
Final answer:A=C; B=B; C=S; D=B
Assign CPR to the pulseless patient, bleeding control to the two pulse-present patients with uncontrolled external hemorrhage, and shock support with rapid transport to the abdominal-trauma patient. No external source is described there. The pulse and bleeding observations distinguish these independent first-action categories.
Question 114
After smoke exposure, a patient initially speaks clearly but develops hoarseness and stridor during transport preparation. The hand burns appear superficial, and a displayed saturation remains 96%. Which change most strongly increases urgency?
☐ A. The unchanged saturation, because it establishes that the airway lumen remains adequate.
☐ B. The earlier clear speech, because new hoarseness is primarily a communication problem.
☐ C. The superficial hand burns, because their small area makes an inhalation complication unlikely.
☐ D. The new hoarseness and stridor, because they suggest evolving upper-airway compromise.
Show answer and explanation
Response:D
Final answer:D. The new hoarseness and stridor, because they suggest evolving upper-airway compromise.
New hoarseness and stridor after smoke exposure warrant urgent airway reassessment and escalation. Airway narrowing may precede desaturation. Earlier clear speech and small superficial skin burns do not exclude an evolving inhalation problem now supported by the changed voice and airflow sounds.
Question 115
An autistic child with a painful arm covers the ears when several responders speak. The caregiver says the child usually communicates well if one person speaks quietly and pauses for a reply. Which approach best uses this information?
☐ A. Use several speakers in turn without pauses so the child hears the message repeatedly.
☐ B. Use one quiet speaker, allow response time, and explain individual assessment steps.
☐ C. Ask the caregiver to answer immediately whenever the child hesitates, without allowing a pause.
☐ D. Continue questions while palpating the injury so speech and touch finish together.
Show answer and explanation
Response:B
Final answer:B. Use one quiet speaker, allow response time, and explain individual assessment steps.
Use the caregiver's patient-specific strategy: one quiet speaker, pauses for a response and explanation before individual steps or touch. The child can communicate. Preserve that opportunity instead of replacing answers immediately or adding repeated questions from several people.
Question 116
A supplied unit policy requires four usable small pediatric masks and three usable larger pediatric masks. Only intact, unexpired masks count. Small masks: five present, two torn. Larger masks: four present, two expired. What minimum replacement stock is needed to meet both minimums?
☐ A. One small mask and one larger mask.
☐ B. No replacements; both physical counts exceed the minimums.
☐ C. One small mask and no larger masks.
☐ D. Two small masks and two larger masks.
Show answer and explanation
Response:A
Final answer:A. One small mask and one larger mask.
Subtract unusable masks within each size: five minus two leaves three small masks, and four minus two leaves two large masks. Add one of each. Those additions meet four and three respectively, whereas replacing every unusable mask exceeds the requested minimum deficit.
Question 117
After ventilation support, an adult's reliable SpO2 rises from 88% to 95%. Meanwhile, pulse rises from 112 to 138/min, pressure falls from 104/70 to 82/60 mmHg, and the patient becomes confused. Which overall conclusion is best supported?
☐ A. Oxygenation improved, but the falling pressure and altered mentation indicate worsening circulation.
☐ B. The supported saturation confirms adequate tissue perfusion, while the confusion is an isolated neurologic issue.
☐ C. The faster pulse establishes restored circulation even though blood pressure is lower.
☐ D. The respiratory response establishes overall recovery, allowing the pressure trend to be deferred.
Show answer and explanation
Response:A
Final answer:A. Oxygenation improved, but the falling pressure and altered mentation indicate worsening circulation.
Give urgent attention to circulation alongside breathing, because a reliable saturation improvement during support can coexist with worsening pressure, pulse and mentation, making the oxygenation response only one part of the serial assessment rather than evidence that overall perfusion has recovered.
Question 118
Dispatch reports a child locked in a hot vehicle, drowsy but still breathing. Rescue personnel are not yet on scene. Which THREE prearrival preparations fit the reported access and heat risks?
Select exactly 3 answers.
☐ A. Confirm the vehicle location and coordinate a qualified access response.
☐ B. Prepare to obtain a core temperature before beginning cooling, using the measurement to decide whether the drowsiness warrants action.
☐ C. Focus prearrival questions on a complete medication and illness history, with rescue coordination left until the crew confirms drowsiness in person.
☐ D. Prepare appropriately sized pediatric airway and ventilation equipment.
☐ E. Plan shade and passive cooling after access, leaving active cooling resources packed until the child's responsiveness has returned.
☐ F. Prepare appropriate cooling resources and prompt transport planning.
Show answer and explanation
Response:A, D, F
Final answer:A. Confirm the vehicle location and coordinate a qualified access response.; D. Prepare appropriately sized pediatric airway and ventilation equipment.; F. Prepare appropriate cooling resources and prompt transport planning.
Arrange qualified access, prepare fitted pediatric breathing equipment and have cooling and transport resources ready for the drowsy child. Access is still blocked. A full background interview or waiting for a temperature measurement and regained alertness before cooling preparation would defer the reported immediate risks.
Question 119
An injured toddler requires spinal motion restriction. In the side-view diagram, the large occiput rests on the flat surface and flexes the neck, bringing the chin toward the chest. Which adjustment best addresses the relationship shown?
☐ A. Maintain the depicted flexion and add a collar to substitute for correcting the position.
☐ B. Raise the head further with padding while leaving the torso at its original level.
☐ C. Raise the torso with appropriate padding to reduce the depicted head-to-torso flexion.
☐ D. Remove all torso support so the head can rest lower despite the unchanged flat surface.
Show answer and explanation
Response:C
Final answer:C. Raise the torso with appropriate padding to reduce the depicted head-to-torso flexion.
Raise the torso relative to the large occiput with suitable padding, then reassess alignment. The diagram shows neck flexion. Adding head padding increases the height mismatch, while a collar cannot correct the underlying relationship without an appropriate supporting position.
Question 120
An infant has vomit in the mouth, eight shallow breaths/min, and a definite pulse with poor perfusion. After suction the airway is clear, but breathing remains ineffective. The supplied rule permits ALS intercept only without delaying the appropriate hospital trip, which takes seven minutes. ALS can meet the direct route in three minutes or reach the scene in twelve. Which continuing care plan best integrates breathing support and transport?
☐ A. Assist at about 20--30 breaths/min, but use an off-route rendezvous adding ten minutes to reach ALS sooner.
☐ B. Assist at about 20--30 breaths/min and hold departure for the twelve-minute scene response.
☐ C. Assist at about 20--30 breaths/min with visible chest rise, departing for the non-delaying direct-route intercept.
☐ D. Depart for the direct-route intercept with assisted breaths at 8/min because that matches the infant's original rate.
Show answer and explanation
Response:C
Final answer:C. Assist at about 20--30 breaths/min with visible chest rise, departing for the non-delaying direct-route intercept.
Assist this pulse-present infant at about 20--30 breaths per minute with visible chest rise while continuing the direct seven-minute trip and coordinating its three-minute on-route intercept, since cleared obstruction has left breathing ineffective and neither a scene wait nor copying the eight-breath baseline meets both needs.